Radiation systems

ABSTRACT

A radiation system includes a first ring, a radiation source capable of providing radiation suitable for treating a patient, the radiation source secured to the first ring, a second ring located behind the first ring, and an imager secured to the second ring. A radiation system includes a first device having a radiation source capable of generating a radiation beam suitable for treating a patient, and a second device having imaging capability, wherein the first device is oriented at an angle that is less than 180° relative to the second device. A radiation system includes a structure having a first opening, a radiation source rotatably coupled to the structure, an imaging device rotatable relative to the structure, and a processor for controlling a rotation of the radiation source and a rotation of the imaging device, wherein the radiation source is rotatable relative to the imaging device.

RELATED APPLICATION DATA

This application claims the benefit of U.S. Provisional PatentApplication No. 60/676,138, filed on Apr. 29, 2005, the entiredisclosure of which is expressly incorporated by reference herein.

This application is related to U.S. patent application Ser. No.11/415,965, filed on May 1, 2006, U.S. patent application Ser. No.11/415,974, filed on May 1, 2006, and U.S. patent application Ser. No.11/415,957, filed on May 1, 2006.

FIELD

This application relates generally to radiation systems, and moreparticularly, to radiation systems having imaging capability.

BACKGROUND

Various systems and methods exist to provide radiation therapy treatmentof tumorous tissue with high-energy radiation. While some patientconditions require whole body radiation treatments, many forms ofradiation treatment benefit from the ability to accurately control theamount, location and distribution of radiation within a patient's body.Such control often includes applying various levels of radiation tovarious areas of the tumorous region. For example, in some instances itis desirable to apply a greater dosage of radiation to one portion of atumorous region than another. As another example, in some instances itis desirable to minimize the dosage of radiation to non tumorous regionswhere radiation may have deleterious effects. Due to a variety ofcontributing factors, achieving accurate control of the amount, locationand distribution of radiation within the patient's body can bedifficult. Among these factors are movement in the patient's body,changes in organ or inter organ structure or composition, and changes inthe relative position of a patient's organs.

Prior to a radiation therapy, the patient undergoes an imaging procedureto determine the exact size, shape and location of the tumorous region.In a radiation treatment session, the patient is subjected to radiationfrom an accelerator that emits a beam of radiation energy collimated andoriented to enter the patient's body from a particular angle. Varyingthe intensity and the entry angle of the incident radiation beam allowsa radiation specialist to generate a radiation dose volume thatcorresponds to the size, shape, and location of the tumorous region.

Several factors may prevent optimal radiation exposure to the tumorousregion and minimal radiation exposure of the healthy tissue regions. Forexample, minor changes in patient's position from the imaging device tothe treatment device may radically alter the position of the tumorousregion or organ. In existing procedures, the patient is generally placedon a first patient support when the imaging device is used to obtainimages of the patient. After the imaging session, the patient is thenmoved to a second patient support where the patient can be treated in atreatment session. As a result of moving the patient to differentsupports, the position and/or the shape of the target tissue within thepatient may change. As such, it may be desirable to provide a radiationsystem that allows a transportation distance for the patient between thediagnostic device and the treatment device to be minimized, or at leastreduced, thereby reducing the chance of having the target tissue changeposition and/or shape.

In some radiation procedures, such as a Positron emission tomography andcomputed tomography (PET-CT), a patient may be positioned between twodiagnostic devices. PET detects photons generated throughpositron-electron annihilation of positrons from a radioactive tracerplaced in the object, e.g., patient, to be imaged, and analyzes thephoton energy and trajectory to generate tomographic images of thepatient. PET images may be used to identify areas where a tumor isactively growing. However, due to attenuation effect in PET procedures,PET images tend to be blurry. As such, it may be desirable to obtaininformation about an anatomy, such as a density of tissue, that is beingimaged, and use such information to correct attenuation effect in PETimaging. CT imaging may be used to obtain density information, andtherefore, may be used to correct attenuation effect in PET images. Inexisting PET-CT procedures, the patient is generally placed in a firstoperative position associated with the PET device, and a PET imagingprocedure is performed to obtain PET images of the patient. After thePET imaging session, the patient may be moved to a second operativeposition associated with the CT device, and a CT imaging procedure isperformed to obtain CT or x-ray images of the patient. The CT image dataobtained using the CT device may then be used to perform attenuationcorrection for the PET images obtained using the PET device. As a resultof moving the patient between the PET and CT devices, the positionand/or the shape of the target tissue within the patient may change. Insome cases, the PET and CT devices may be combined in a single machine.However, in such systems, the machine can only perform low energyimaging of the patient, and is not capable of providing treatment to thepatient.

SUMMARY

In accordance with some embodiments, a radiation system includes astructure having a first side, a second side, a first opening located onthe first side, a second opening located on the second side, and a boreextending between the first opening and the second opening, and a firstradiation source configured for emitting treatment radiation, whereinthe first radiation source is located outside the bore.

In accordance with other embodiments, a radiation system includes afirst ring, a radiation source capable of providing radiation suitablefor treating a patient, the radiation source secured to the first ring,a second ring located behind the first ring, and an imager secured tothe second ring.

In accordance with other embodiments, a radiation system includes afirst device having a radiation source capable of generating a radiationbeam suitable for treating a patient, and a second device having imagingcapability, wherein the first device is oriented at an angle that isless than 180° relative to the second device.

In accordance with other embodiments, a radiation system includes astructure having a first opening, a radiation source rotatably coupledto the structure, an imaging device rotatable relative to the structure,and a processor for controlling a rotation of the radiation source and arotation of the imaging device, wherein the radiation source isrotatable relative to the imaging device.

In accordance with other embodiments, a radiation system includes astructure, a first radiation source coupled to the structure, and adocking system associated with the structure.

Other aspects and features will be evident from reading the followingdetailed description of the embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawings illustrate the design and utility of preferred embodiments,in which similar elements are referred to by common reference numerals.In order to better appreciate how advantages and objects of theembodiments are obtained, a more particular description of theembodiments will be illustrated in the accompanying drawings.

FIG. 1A illustrates an isometric view of a radiation system inaccordance with some embodiments;

FIG. 1B illustrates an isometric view of a radiation system havingimaging capability in accordance with some embodiments;

FIG. 1C illustrates an isometric view of a radiation system inaccordance with other embodiments;

FIG. 1D illustrates an isometric view of a radiation system inaccordance with other embodiments;

FIG. 1E illustrates a top view of the radiation system of FIG. 1C inaccordance with some embodiments;

FIG. 1F illustrates an isometric view of a radiation system inaccordance with other embodiments;

FIG. 2 illustrates an isometric view of a radiation system thatincludes, or is used with, a computed tomography device, in accordancewith some embodiments;

FIG. 3 illustrates an isometric view of a radiation system thatincludes, or is used with, a device having a C-arm configuration, inaccordance with some embodiments;

FIG. 4A illustrates an isometric view of a radiation system having adocking system for allowing a device to be docked adjacent to theradiation system in accordance with some embodiments;

FIGS. 4B and 4C illustrate a method of docking a device adjacent to theradiation system of FIG. 4A in accordance with some embodiments;

FIG. 5A illustrates an isometric view of a radiation system having adocking system for allowing the radiation system to be docked adjacentto a device in accordance with some embodiments;

FIGS. 5B and 5C illustrate a method of docking the radiation system ofFIG. 5A adjacent to a device in accordance with some embodiments;

FIG. 6A illustrates a side view of a patient support system inaccordance with some embodiments, showing the patient support systemplaced on one side of the radiation system of FIG. 1A;

FIG. 6B illustrates a side view of a patient support system inaccordance with other embodiments, showing the patient support systemplaced on another side of the radiation system of FIG. 1A;

FIG. 7 illustrates a side view of the patient support system of FIG. 6A,showing a patient support of the patient support system being placed ata first operative position;

FIG. 8 illustrates a side view of the patient support system of FIG. 6A,showing a patient support of the patient support system being placed ata second operative position;

FIG. 9 illustrates a side view of a patient support system in accordancewith some embodiments;

FIG. 10A illustrates a side view of a patient support system inaccordance with other embodiments;

FIG. 10B illustrates a top view of a docking system for allowing apatient support system to be docked adjacent to a radiation system inaccordance with some embodiments;

FIG. 10C illustrates a top view of the patient support system of FIG.10A docked adjacent to the radiation system of FIG. 1A in a firstconfiguration in accordance with some embodiments;

FIG. 10D illustrates a top view of the patient support system of FIG.10A docked adjacent to the radiation system of FIG. 1A in a secondconfiguration in accordance with other embodiments;

FIG. 10E illustrates a top view of the patient support system of FIG.10A docked adjacent to the radiation system of FIG. 1A in a thirdconfiguration in accordance with other embodiments;

FIG. 10F illustrates a top view of the patient support system of FIG.10A docked adjacent to the radiation system of FIG. 1A in a fourthconfiguration in accordance with other embodiments;

FIG. 10G illustrates a top view of a docking system in accordance withother embodiments;

FIG. 10H illustrates a top view of a docking system in accordance withother embodiments;

FIG. 11A illustrates a side view of a patient support system placedbetween a radiation system and a device in accordance with someembodiments, showing a patient support of the patient support systemplaced at a first operative position;

FIG. 11B illustrates a side view of the patient support system of FIG.11A, showing the patient support of the patient support system placed ata second operative position;

FIG. 12A illustrates a side view of a patient support system having afirst positioner, a second positioner, and a patient support inaccordance with some embodiments, wherein the patient support is showncoupled to the first positioner;

FIG. 12B illustrates a side view of the patient support system of FIG.12A, showing the patient support being coupled to both the first and thesecond positioners;

FIG. 12C illustrates a side view of the patient support system of FIG.12A, showing the patient support being coupled to the second positioner;

FIG. 13A illustrates a patient support system in accordance with otherembodiments;

FIG. 13B illustrates a patient support system in accordance with otherembodiments;

FIG. 13C illustrates a method of using the patient support of FIG. 13Ain accordance with some embodiments;

FIG. 13D illustrates an isometric view of a patient support inaccordance with other embodiments;

FIG. 13E illustrates an isometric view of a patient support inaccordance with other embodiments;

FIG. 14A illustrates an isometric view of a radiation system thatincludes a patient position sensing system in accordance with someembodiments;

FIG. 14B illustrates a side view of a radiation system that includes apatient position sensing system in accordance with other embodiments;

FIG. 14C illustrates a side view of a radiation system that includes apatient position sensing system in accordance with other embodiments;

FIG. 15 illustrates an isometric view of a radiation system thatincludes compensating coils in accordance with some embodiments;

FIG. 16A illustrates an isometric view of a radiation system thatincludes a protective shield in accordance with some embodiments;

FIG. 16B illustrates a side cross-sectional view of the radiation systemof FIG. 16A;

FIG. 16C illustrates an isometric view of a radiation system thatincludes a protective shield in accordance with other embodiments;

FIGS. 17A-17E illustrate radiation systems in accordance with otherembodiments;

FIG. 18 illustrates a radiation beam generator having a permanent magnetfor altering a trajectory of a beam in accordance with some embodiments;and

FIG. 19 illustrates a block diagram of a computer system that can beused to control an operation of a radiation system, a device, and/or apatient support system in accordance with some embodiments.

DETAILED DESCRIPTION OF THE EMBODIMENTS

Various embodiments are described hereinafter with reference to thefigures. It should be noted that the figures are not drawn to scale andelements of similar structures or functions are represented by likereference numerals throughout the figures. It should also be noted thatthe figures are only intended to facilitate the description of specificembodiments. They are not intended as an exhaustive description of theinvention or as a limitation on the scope of the invention. In addition,an aspect described in conjunction with a particular embodiment is notnecessarily limited to that embodiment and can be practiced in any otherembodiments. Moreover, alternative configurations, components, methods,etc. discussed in conjunction with one embodiment can be used in anyother embodiment even if such other embodiment does not discuss suchalternatives or discusses different alternatives.

FIG. 1A illustrates a radiation system 10 in accordance with someembodiments. The radiation system 10 includes a structure 12 having afirst side 14, a second side 16, a first opening 18 located on the firstside 14, a second opening 20 located on the second side 16, and a bore22 extending between the first and second openings 18, 20. In theillustrated embodiments, the openings 18, 20 are circular in shape andare sized for accommodating at least a part of a patient. In otherembodiments, the openings 18, 20 can have other shapes. The through bore22 of the structure 12 provides a passage for allowing at least aportion of a patient to be transported from one side of the structure 12to an opposite side of the structure 12. In some embodiments, adiagnostic procedure (e.g., an imaging procedure) is performed on thepatient on one side of the structure 12 (e.g., for the purpose ofobtaining information, such as a position of a target region, of thepatient), and the patient is then transported through the bore 22 to theopposite side of the structure 12 for a treatment procedure. In otherembodiments, the patient is treated on one side of the structure 12, andis then transported through the bore 22 to the opposite side of thestructure 12 for further procedure(s), such as a diagnostic procedure(e.g., to evaluate a treatment procedure, or to verify location,orientation, and/or shape of a target tissue,) or a treatment procedure.

It should be noted that the shape and configuration of the structure 12should not be limited to the examples discussed previously, and that thestructure 12 can have other configurations in other embodiments. Forexample, in other embodiments, the structure 12 can have a curvilinearshape, or other shapes. Also, in some embodiments, the structure 12 canhave a size and shape such that the structure can house mechanical andelectrical components associated with an operation of the radiationsystem 10 as desired. The radiation system 10 also includes a firstradiation source 40 located adjacent to the first side 14 for deliveringa radiation beam 42. The radiation beam 42 can be a pencil beam, a fanbeam, a cone beam, or other types of beams having differentconfigurations. As used in this specification, the term “radiationsource” refers to an emission point/region of a radiation beam (e.g.,radiation beam 42), and may or may not include components, such as aparticle generator, an accelerator, a cooling system, a shielding, etc.,that are used to generate the radiation beam 42. As shown in the figure,the radiation system 10 includes an arm 30 secured to the structure 12,and the first radiation source 40 is secured to the arm 30. Some or allof the components used to generate the radiation beam 42 can be housedwithin the arm 30, the structure 12, a separate housing (not shown), orcombination thereof. For example, in some embodiments, the accelerator31 associated with the radiation source 40 may be housed within the arm30. In such cases, one or more magnets (electromagnet(s) or permanentmagnet(s)) may be provided within the arm 30 for changing acharacteristic (e.g., a trajectory) of an electron beam created by theaccelerator 31. If permanent magnet(s) is used, its associated magneticfield can be trimmed electromagnetically (e.g., using one or moreelectromagnetic coil(s)) or mechanically (e.g., using one or morepermanent magnet(s)). Also, in some embodiments, the mechanical trimmingcan be performed using a magnetic shunt. Magnetic field trimming will bedescribed with reference to FIG. 18.

As shown in the figure, the arm 30 is secured to a mechanical linkage44, such as a ring, that is rotatable relative to the structure 12,thereby allowing the first radiation source 40 to rotate about an axis46 of the bore 22. The arm 30 of the radiation system 10 is advantageousin that it allows radiation be delivered to a portion of a patient thatis placed outside the bore 22. In particular, since the patient is notconfined by the bore 22, the patient can be oriented at different anglesrelative to the axis 46 outside the bore 22. For example, the patientcan be positioned at least partially outside the bore 22 and oriented atan angle relative to the axis 46. In some embodiments, the arm 30 isalso advantageous in that it can be used to house at least some of thecomponents, such as an accelerator, associated with the radiation source40, thereby eliminating the need to cramp the components within the bore22.

In other embodiments, or any of the embodiments described herein, theradiation system 10 may not include the arm 30 (FIG. 1F). In such cases,the first radiation source 40 may be rotatably secured to the structure12. For example, the radiation source 40 may be secured to a ring (whichmay be a full ring or a partial ring) that is rotatable relative to thestructure 12 in a slip-ring configuration. In such cases, at least someof the components within arm 30 may be disposed within the structure 12.It should be noted that any one or a combination of any of the featuresdescribed herein may be incorporated and implemented with the radiationsystem 10 of FIG. 1F, and that a configuration where a radiation sourcesuch as source 40 is within a ring can be incorporated and implementedin any embodiments such as those illustrated or described herein.

In the illustrated embodiments, the first radiation source 40 is atreatment radiation source for providing treatment energy. In suchcases, the radiation system 10 further includes one or more collimators(not shown) for controlling a delivery of the radiation beam 42 (e.g.,changing a shape of the beam 42). A collimator can be, for example, amulti-leaf collimator, which is known in the art. Alternatively, thefirst radiation source 40 can be a diagnostic radiation source forproviding diagnostic energy. In some embodiments, the treatment energyis generally those energies of 160 keV or greater, and more typically 1MeV or greater, and diagnostic energy is generally those energies belowthe high energy range, and more typically below 160 keV. In otherembodiments, the treatment energy and the diagnostic energy can haveother energy levels, and refer to energies that are used for treatmentand diagnostic purposes, respectively. For example, a radiation beamhaving an energy level that is typically used for treatment purpose maybe considered as having a diagnostic energy level if the radiation beamis used for diagnostic purpose (e.g., for imaging). As such, the term“treatment energy” and the term “diagnostic energy” should not belimited to energy levels having certain magnitudes. In furtherembodiments, the first radiation source 40 is a multi-energy x-raysource that is capable of providing radiation energy at different energylevels. By way of example, the first radiation source 40 is able togenerate X-ray radiation at a plurality of photon energy levels within arange anywhere between approximately 10 kilo-electron-volts (keV) andapproximately 20 mega-electron-volts (MeV). Radiation sources capable ofgenerating X-ray radiation at different energy levels are described inU.S. patent application Ser. No. 10/033,327, entitled “RADIOTHERAPYAPPARATUS EQUIPPED WITH AN ARTICULABLE GANTRY FOR POSITIONING AN IMAGINGUNIT,” filed on Nov. 2, 2001, and U.S. patent application Ser. No.10/687,573, entitled “MULTI-ENERGY X-RAY SOURCE,” filed on Oct. 15,2003, both of which are expressly incorporated by reference in theirentirety.

In some embodiments, the radiation system 10 further includes a controlsystem 78. The control system 78 includes a processor 84, such as acomputer processor, coupled to a control 80. The control system 78 mayalso include a monitor 86 for displaying data and an input device 88,such as a keyboard or a mouse, for inputting data. In some embodiments,during an operation of the radiation system 10, the radiation source 40rotates about the patient (e.g., as in an arc-therapy). The rotation andthe operation of the radiation source 40 are controlled by the control80, which provides power and timing signals to the radiation source 40and controls a rotational speed and position of the radiation source 40based on signals received from the processor 84. Although the control 80is shown as a separate component from the structure 12 and the processor84, in alternative embodiments, the control 80 can be a part of thestructure 12 or the processor 84.

In any of the embodiments described herein, the radiation system 10 canfurther include an imager 50 located next to the first opening 18 andopposite from the radiation source 40 (FIG. 1B). In some embodiments,the imager 50 includes a conversion layer made from a scintillatorelement, such as Cesium Iodide (Csl), and a photo detector array (e.g.,a photodiode layer) coupled to the conversion layer. The conversionlayer generates light photons in response to radiation, and the photodetector array, which includes a plurality of detector elements, isconfigured to generate electrical signal in response to the lightphotons from the conversion layer. The imager 50 can have a curvilinearsurface (e.g., a partial circular arc). Such configuration is beneficialin that each of the imaging elements of the imager 50 is locatedsubstantially the same distance from the radiation source 40. In analternative embodiment, the imager 50 may have a rectilinear surface ora surface having other profiles. The imager 50 can be made fromamorphous silicon, crystal and silicon wafers, crystal and siliconsubstrate, or flexible substrate (e.g., plastic), and may be constructedusing flat panel technologies or other techniques known in the art ofmaking imaging device. In alternative embodiments, the imager 50 may usedifferent detection schemes. For example, in alternative embodiments,instead of having the conversion layer, the imager 50 may include aphotoconductor, which generates electron-hole-pairs or charges inresponse to radiation.

It should be noted that the configuration of the imager 50 should not belimited to the examples discussed previously, and that imagers havingother configurations may be used in other embodiments. By way ofexample, U.S. patent application Ser. No. 10/439,350, entitled “MULTIENERGY X-RAY IMAGER” filed on May 15, 2003, discloses imaging devicescapable of generating signals in response to multiple radiation energylevels, and can be used as the imager 50 in accordance with someembodiments. In addition, U.S. patent application Ser. No. 10/013,199,entitled “X-RAY IMAGE ACQUISITION APPARATUS,” and filed on Nov. 2, 2001,discloses an image detecting device that is capable of detectingmultiple energy level X-ray images, and can also be used as the imager50 in accordance with other embodiments. U.S. patent application Ser.No. 10/687,552, entitled “MULTI-ENERGY RADIATION DETECTOR,” and filed onOct. 15, 2003, discloses multi-energy radiation detectors that can beused as the imager 50 in different embodiments. In other embodiments,the imager 50 can be implemented using flat panel technologies. Also, infurther embodiments, the imager 50 can be a multi-slice flat panel.Multi-slice flat panel CT has been described in U.S. patent applicationSer. No. 10/687,552, entitled “MULTI-SLICE FLAT PANEL COMPUTEDTOMOGRAPHY,” and filed on Oct. 15, 2003. U.S. patent application Ser.Nos. 10/439,350, 10/013,199, and 10/687,550 are expressly incorporatedby reference in their entirety. In other embodiments, the imager 50 maybe similarly incorporated in the radiation system 10 of FIG. 1F, or inany of the radiation systems 10 described herein.

It should be noted that the radiation system 10 should not be limited tothe configuration discussed previously, and that the radiation system 10can have other configurations in other embodiments. For example, in someembodiments, the radiation system 10 can have the configuration shown inFIG. 1C. In the illustrated embodiments, the radiation system 10includes the structure 12 a, which has a configuration that is similarto that discussed previously with reference to structure 12 of FIG. 1A.The radiation system 10 also includes the arm 30 and the radiationsource 40. However, in the illustrated embodiments, the arm 30 has aconfiguration that resembles a L-shape, and includes a first portion 54and a second portion 55. The second portion 55 of the arm 30 has a firstopening 19, a second opening 21, and a bore 56 extending between thefirst and the second openings 19, 21. As shown in FIG. 1E, which is atop view of the system of FIG. 1C, the arm 30 is rotatably coupled tothe structure 12 via a cylindrical shaft 49, which circumscribe at leastpart of the bore 22 and at least part of the bore 56 in a coaxialconfiguration. In other embodiments, the arm 30 can be rotatably coupledto the structure 12 in other configurations. The bore 56 is positionedrelative to the bore 22 such that at least a part of a patient can movethrough the bore 56 to the bore 22, and vice versa. In otherembodiments, any of the features described herein can also be includedwith the radiation system 10 of FIG. 1C. For example, in otherembodiments, the radiation source 40 can deliver diagnostic energy, andthe radiation system 10 of FIG. 1C can further include an imager (e.g.,the imager 50) in operative position with the radiation source 40 suchthat the radiation source 40 and the imager can be used to generateimage data.

In some embodiments, any of the radiation systems 10 described hereincan further include a x-ray source, such as tube 51 (an example of animaging device) and an imager 52 (another example of an imaging device)secured to the second portion 54 of the arm 30 (FIG. 1D), wherein thex-ray tube 51 and the imager 52 are positioned to image at least aportion of the patient. The x-ray tube 51 and the imager 52 can be usedto generate data regarding a patient while the patient is positioned inan operative position associated with the radiation source 40. Forexample, in some embodiments, the x-ray tube 51 generates a cone beam,and the imager 52 generates cone beam CT data, which represent image ofa portion of a patient. Alternatively, the imaging devices can be usedfor radiography or fluoroscopic imaging. In the embodiments of FIG. 1A,the x-ray tube 51 and the imager 52 could be attached to ring 44. In theembodiments of FIG. 1F, the x-ray tube 51 and the imager 52 could beattached to the ring 53.

FIG. 2 illustrates the radiation system 10 of FIG. 1A when used with acomputed tomography image acquisition device (CT device) 100. The CTdevice 100 includes a gantry 102 having a bore 103, a patient support114 for supporting a patient 116, and a control system 108 forcontrolling an operation of the gantry 102. In the illustratedembodiments, the gantry 102 has a slip-ring configuration (donut shape).Alternatively, the gantry 102 can have other configurations, such as aC-arm configuration. The CT device 100 also includes a radiation source(e.g., x-ray source) 120 that projects a beam 122 of radiation towards adetector 124 on an opposite side of the gantry 102 while the patient 116is positioned at least partially between the radiation source 120 andthe detector 124. The radiation source 120 can be configured to generatea cone beam (for cone beam computed tomography—“CBCT”). In otherembodiments, the radiation source 120 generates beams having otherconfigurations, such as a fan beam. The detector 124 has a plurality ofsensor elements configured for sensing radiation that passes through thepatient. Each sensor element generates an electrical signalrepresentative of an intensity of the radiation as it passes through thepatient. It will be appreciated that throughout the presentspecification, although specific embodiments of various imaging devicesmay be illustrated by fan beam CT or cone beam CT, any type of CTgenerally can be practiced in any of the embodiments.

The control system 108, includes a processor 134, such as a computerprocessor, coupled to a gantry rotation control 141. The control system108 may also include a monitor 156 for displaying data and an inputdevice 158, such as a keyboard or a mouse, for inputting data. During ascan to acquire x-ray projection data (i.e., CT image data), the gantry102 rotates about the patient. The rotation of the gantry 102 and theoperation of the radiation source 120 are controlled by the gantryrotation control 141, which provides power and timing signals to theradiation source 120 and controls a rotational speed and position of thegantry 102 based on signals received from the processor 134. Althoughthe control 141 is shown as a separate component from the gantry 102 andthe processor 134, in alternative embodiments, the control 141 can be apart of the gantry 102 or the processor 134. In some embodiments, theprocessor 134 and the processor 84 are implemented using a samecomponent, such as a single processor.

During a radiation procedure using the CT device 100, the radiationsource 120 generates and directs a x-ray beam 122 towards the patient116, while the detector 124 measures the x-ray absorption at a pluralityof transmission paths defined by the x-ray beam during the process. Thedetector 124 produces a voltage proportional to the intensity ofincident x-rays, and the voltage is read and digitized for subsequentprocessing in a computer. After image data at different gantry angleshave been collected, the collected data are processed for reconstructionof a matrix (CT image), which constitutes a depiction of a densityfunction of the bodily section being examined. By considering one ormore of such sections, a skilled diagnostician can often diagnosevarious bodily ailments. In some cases, the one or more sections canalso be used to perform treatment planning.

As shown in the figure, an axis 160 of the bore 103 of the CT device 100is substantially parallel with (e.g., within 20° from) the axis 46 ofthe bore 22 of the radiation system 10. Such configuration allows thepatient 116 to be transported between a first operative position (e.g.,the position of the patient 116 when being operated (e.g., treated orimaged) by the radiation source 40 of the radiation system 10) and asecond operative position (e.g., the position of the patient 116 whenbeing operated by the radiation source 120 of the CT device 100). In theillustrated embodiments, the patient 116 can be transported between thefirst and second operative positions by positioning the patient support114 in a linear manner along the axis 46 of the radiation system 10.Patient supports that can be used with the radiation system 10 will bedescribed in further detail later. In the illustrated embodiments, theaxis 160 of the bore 103 aligns with the axis 46 of the bore 22. Inother embodiments, the axis 160 of the bore 103 may not align with theaxis 46 of the bore 22. For example, in some embodiments, the axis ofthe bore 160 may be offset from the axis 46 of the bore 22.

In the illustrated embodiments of FIG. 2, the processor 134 used tocontrol an operation of the CT device 100 is also coupled to theradiation system 10, and is configured to control an operation of theradiation system 10. Alternatively, a separate control system (e.g., thesystem 78) can be used to control an operation of the radiation system10. Also, in some embodiments, the radiation system 10 includes the CTdevice 100. In such cases, the CT device 100 can be separated from theradiation system 10 as that shown in the figure. Alternatively, the CTdevice 100 can be integrated with the radiation system 10 as a singleunit.

In some embodiments, the electron accelerator 31 associated with theradiation source 40 may cause interference with the device 100. In suchcases, a shield (not shown) can be placed between the accelerator 31 andthe device 100 to prevent, or at least minimize the effect of,interference due to the accelerator 31. The shield can be made fromMumetal or other materials. In some embodiments, the shield can beplaced around the accelerator 31. In other embodiments, the shield canbe placed around the device 100 or a component (e.g., a component thatmay be affected by a magnetic field from the accelerator 31) of thedevice 100. In other embodiments, the shield can be secured to thestructure 12, such as to the second side 16 of the structure 12.

It should be noted that the devices that can be used/included with theradiation system 10 should not be limited to the CT device 100 discussedpreviously, and that a variety of forms of medical devices (e.g.,devices with a ring gantry) can be used/included with the radiationsystem 10 in other embodiments. For example, in some embodiments, thedevice 100 used/included with the radiation system 10 may be adiagnostic/treatment device having a C-arm configuration (FIG. 3). Thedevice 100 is positioned relative to the bore 22 such that a patient canbe positioned between a first operative position associated with theradiation source 40, and a second operative position associated with thedevice 100. In any embodiment, the device 100 can be any diagnosticdevice, such as a laminar tomography device, a MRI device, afluoroscope, an angiography device, a PET device, a SPECT device, aPET-CT device, a tomosynthesis imaging device, a CT device, a CBCTdevice, etc. that can be used/included with the radiation system 10. Insuch cases, the diagnostic device 100 is positioned relative to the bore22 such that a patient can be positioned between a first operativeposition associated with the radiation source 40, and a second operativeposition associated with the diagnostic device. In further embodiments,the device 100 used/included with the radiation system 10 may include aplurality of diagnostic devices (e.g., any multiple, or any combination,of the diagnostic devices described).

In the above embodiments, the radiation system 10 can further includerollers that allows the radiation system 10 to be “rolled” to a desiredposition. After the radiation system 10 is desirably positioned, therollers may be locked to thereby prevent the radiation system 10 frommoving. For example, the rollers may be locked during an operation. Therollers are advantageous because it allows the flexibility to readilymove the radiation system 10 (e.g., before an operation, or during anoperation). In other embodiments, the rollers are optional, and theradiation system 10 is fixedly secured to a floor of an operation room.

In some embodiments, the radiation system 10 can further include adocking system that allows a device 100 to be docked next to the secondopening 20 in a desired relationship (either during an operation, orbefore an operation). Various techniques can be employed to implementthe docking feature of the radiation system 10. FIG. 4A illustrates theradiation system 10 of FIG. 1A that includes a docking system 160 forallowing a device 166 to be docked next to the structure 12. The device166 is represented as a block diagram, and can be a treatment device ora diagnostic device (such as any of the devices 100 discussedpreviously). In the illustrated embodiments, the docking system 160 is arail system that includes a first rail 162 and a second rail 164 locatedadjacent to the second side 16 of the radiation system 10. The rails162, 164 can be secured to the radiation system 10, a floor at which theradiation system 10 sits, or a platform (not shown) that is itselfsecured to the radiation system 10 or the floor. The rails 162, 164 eachhave a substantially rectilinear profile, but can have a curvilinearprofile in other embodiments. Also, in other embodiments, the dockingsystem 160 can have less than two (e.g., one) rails, or more than tworails.

FIGS. 4B and 4C illustrate a method of docking a device 166 adjacent tothe second side 16 of the radiation system 10 in accordance with someembodiments. The device 166 is represented as a block diagram, and canbe a treatment device or a diagnostic device (such as any of the devices100 discussed previously). As shown in FIG. 4B, before the device 166 isdocked, the device 166 is positioned such that its wheels/rollers 168are aligned with the rails 162, 164 of the docking system 160. Thedevice 166 is then advanced such that the rollers 168 engage with thedocking system 160. Next, the device 166 is further advanced, whileguided by the docking system 160, until the device 166 is docked next tothe second opening 20 of the radiation system 10 (FIG. 4C). In someembodiments, the docking system 160 can further include a locking device(not shown), which can be used to lock the device 166 in place when thedevice 166 is desirably positioned.

In some embodiments, the position of one or both of the rails 162, 164of the docking system 160 can be adjusted such that the docking system160 can accommodate different devices 166 having differentconfigurations. For example, in some embodiments, the distance betweenthe rails 162, 164 can be varied such that devices 166 having differentroller spacing can be docked. Also, in other embodiments, one or morerails can be removed or added to the docking system 160 for allowingdevices 166 having different number of rollers to be docked. In someembodiments, the docking system 160 can further include the rollers 168of the device 166.

It should be noted that the docking system 160 should not be limited tothe example discussed previously, and that the docking system 160 can beimplemented using other techniques. For example, in other embodiments,instead of, or in addition to rail(s), the structure 12 and the device166 can have a key-type docking mechanism, which allows a portion of thestructure 12 to mate with a portion of the device 166, or otheralignment devices, including visual alignment marks, sensors, or othermeans, which allow the device 166 to be positioned in a desiredrelationship relative to the radiation system 10. In furtherembodiments, the device 166 does not include rollers 168. Instead, thedevice 166 can be positioned using a crane, air cushion, a positioner,glide block(s), or other transportation mechanism.

In some embodiments, instead of, or in addition to, the docking system160, the radiation system 10 can further include a docking system 170for allowing the structure 12 to be docked into a desired position.Various techniques can be employed to implement the docking feature ofthe radiation system 10.

FIG. 5A illustrates the radiation system 10 of FIG. 1A that includes adocking system 170. In the illustrated embodiments, the docking system170 includes a roller system having a set of first roller(s) 172 and asecond set of roller(s) 174 located adjacent to a bottom portion of theradiation system 10. In other embodiments, the docking system 170 canhave less than two (e.g., one) roller, or more than sets of two rollers.In the illustrated embodiments, the roller sets 172, 174 are configuredto mate with rails 176, 178 of a rail system 180. The rail system 180can be secured to another device, such as the device 166, a floor atwhich the radiation system 10 sits, or a platform that is placed againsta floor or secured to the device 166. The rails 176, 178 each have asubstantially rectilinear profile, but can have a curvilinear profile inother embodiments. In some embodiments, the docking system 170 canfurther includes the rail system 180.

FIGS. 5B and 5C illustrate a method of docking the radiation system 10to a desired position, e.g., adjacent to the device 166, in accordancewith some embodiments. The device 166 is represented as a block diagram,and can be a treatment device or a diagnostic device (such as any ofthose discussed previously). As shown in FIG. 5B, before the radiationsystem 10 is docked, the radiation system 10 is positioned such that itsroller sets 172, 174 are aligned with the rails 176, 178. The radiationsystem 10 is then advanced such that the roller sets 172, 174 engagewith the rails 176, 178, respectively. Next, the radiation system 10 isfurther advanced, while guided by the rails 176, 178, until theradiation system 10 is docked next to the device 166 (FIG. 5C). In someembodiments, the docking system 170 can further include a locking device(not shown), such as a brake system, which can be used to lock theradiation system 10 in place when the radiation system 10 is desirablypositioned.

In some embodiments, the position of one or both of the roller sets 172,174 of the docking system 170 can be adjusted such that the radiationsystem 10 can be mated with rails having different configurations. Forexample, in some embodiments, the distance between the roller sets 172,174 can be varied such that the radiation system 10 can be docked withrails having different spacing. Also, in other embodiments, one or moreroller sets can be removed or added to the docking system 170 forallowing the radiation system 10 to dock with a rail system havingdifferent number of rails.

It should be noted that the docking system 170 should not be limited tothe example discussed previously, and that the docking system 170 can beimplemented using other techniques. For example, in other embodiments,the structure 12 and the device 166 can have a key-type dockingmechanism, which allows a portion of the structure 12 to mate with aportion of the device 166. In alternative embodiments, the dockingsystem 170 can have a first portion (e.g., a protrusion) associated withthe radiation system 10, and a second portion (e.g., a component havinga recess) associated with the device 166, wherein the first portionand/or the second portion are configured to mate with each other. Thefirst and second portions of a docking system can be implemented usingany machinery, device, or system known in the art, including thosedescribed earlier in relation to FIGS. 4A-4C. In other embodiments, theradiation system 10 can include other alignment devices, which allow theradiation system 10 to be positioned in a desired relationship relativeto the device 166. In further embodiments, the radiation system 10 doesnot include the roller system. Instead, the radiation system 10 can bepositioned using a crane, air cushion, a positioner, glide block(s), orother transportation mechanism.

In any of the docking systems described herein, the docking system canfurther include one or more facilities, such as a water line, anelectricity connection, an oil supply, etc., that connects to the device(such as the structure 12 or the device 166) as the device is beingdocked (or after the device is docked). In some embodiments, thefacilities can be located on, underneath a floor, or underneath aplatform that is secured to the floor. Alternatively, or additionally,the docking system can allow for provision of facilities from onedevice, such as device 12, to one or more others.

Also, in any of the docking systems described herein, the docking systemcan further include a communication system that allows one device tocommunicate with the device 166 or another device. For example, in someembodiments in which the device 166 is being docked, the structure 12includes a signal receiver and/or a transmitter, and the device 166includes a signal transmitter and/or a receiver. During use, the signaltransmitter of, e.g., the device 166 transmits signals to the structure12 regarding a position of the device 166 (e.g., relative to aprescribed coordinate system). The signal receiver of the structure 12receives the transmitted signal, and generates an output based on thetransmitted signal. In some embodiments, the output can be displayed ona user interface, such as a computer screen, which allows an operator toperform an action based on the output. In other embodiments, the devicescan perform or assist in docking (including, e.g., gross positioningand/or fine positioning). For example, the device 166 can be configuredto automatically position itself based on the received output. Infurther embodiments, the structure 12 can include a position sensorwhich senses a position of the device 166, and a transmitter thattransmits steering signals to the device 166. In such cases, the device166 includes a receiver, which receives the steering signals and steersitself into a desired position relative to the structure 12 based on thesteering signals. Other communication techniques can also be used inother embodiments.

FIG. 6A illustrates a patient support system 200 that can be used withany of the embodiments of the radiation system 10 described herein, orwith any radiation system, such as a treatment device or a diagnosticdevice. The patient support system 200 includes a patient support 201having a first end 202, a second end 204, and a support surface 206 thatextends between the first and second ends 202, 204. In some embodiments,the support surface 206 of the patient support 201 can include aplurality of envelopes that can be filled with a fluid (gas or liquid).The envelopes can be selectively filled to create a desired topographyof the support surface 206, thereby allowing a patient to be correctlyplaced on the support surface 206. For example, in some embodiments, theenvelopes adjacent the perimeter of the support surface 206 can beselectively filled to create a recess in a center portion of the supportsurface 206. Alternatively, small individual regions can havemechanically or thermally positionable mechanisms to provide variousshapes in the support surface. The shape of the support surface 206 canaccommodate a shape of a patient or a portion thereof. The precise shapefor a given patient determined, e.g., during treatment planning or aprevious session, can be stored and used later such that when thepatient lies on the support surface 206, the patient will be correctlypositioned relative to the support surface 206. In other embodiments,the support surface 206 does not include the envelopes or otherpositionable mechanism.

The patient support system 200 also includes a positioner 208(represented as a block diagram) for positioning the patient support201. In particular, the positioner 208 is configured to position thepatient support 201 at a first operative position such that radiationbeam from the radiation source 40 can be delivered to a portion 117(e.g., a target region) of the patient 116 (FIG. 7), and a secondoperative position such that the device 166 can be used to operate onthe portion 117 of the patient 116 (FIG. 8). As shown in FIGS. 7 and 8,the portion 117 of the patient 116 is positioned on (adjacent to) thefirst side 14 of the structure 12 when it is being treated by theradiation source 40, and is positioned on (adjacent to) the second side16 of the structure 12 (e.g., within a gantry of the device 166) when itis being imaged by the device 166. In the illustrated embodiments ofFIGS. 6A, 7, and 8, the patient support system 200 is located on thefirst side 14 of the structure 12. Alternatively, the patient supportsystem 200 (or any of the patient support systems described herein) canbe located on the second side 16 of the structure 12 (FIG. 6B). In suchcases, the positioner 208 places the patient support 201 at the firstoperative position associated with the radiation source 40 bytranslating at least a part of the patient support 201 past the device166.

In some embodiments, the device 166 is an imaging device, such as a CTdevice. In such cases, the positioner 208 can be used to position thepatient support 201 (and therefore, the patient 116) at the secondoperative position associated with the imaging device 166, therebyallowing the imaging device 166 to obtain image data of an internalbodily structure of the patient 116. The obtained image data can then beused to create, or modify, a treatment plan, or to perform patientpositioning. In some embodiments, the treatment plan includes parameters(such as a size and shape of a target region, an amount of radiation tobe delivered to the target region, margin requirements, etc.) that canbe used in a radiation treatment session to treat a portion of thepatient 116. Methods of creating treatment plans using image data areknown to those skilled in the art.

In some embodiments, the obtained image data can be used to verify aposition, orientation, and/or a shape, of a target region (e.g., atissue intended to be treated with radiation). For example, the obtainedimage data using the imaging device 166 can be compared against apreviously obtained image data associated with the treatment plan todetermine whether a target region has changed location, size, or shape.After a position, orientation, and/or a shape of the target region hasbeen verified, the positioner 208 can position the patient 116 to thefirst operative position, at which the radiation source 40 can be usedto deliver radiation beam 42 to treat the patient 116.

In some embodiments, the positioner 208 does not move the patient 116while radiation is being delivered to the patient 116 from the radiationsource 40. In other embodiments, the positioner 208 can be used to movethe patient 116 while radiation is being delivered from the radiationsource.

In some embodiments, after the patient 116 has been treated, thepositioner 208 can be used to position the patient 116 from a firstoperative position to a second operative position. While the patient 116is at the second operative position, the imaging device 166 is used toobtain image data of the treated area of the patient 116. The obtainedimage data can then be used to determine an effect (e.g., aneffectiveness, accuracy, etc.) of the previously performed treatmentprocedure. In some embodiments, the obtained image data can be used todetermine a next treatment plan (for a next treatment session) based ona treatment result from an earlier treatment session. For example, theobtained image data may be used to create the next treatment plan, or tomodify a previously determined treatment plan, for a next treatment(e.g., next radiation segment, or next radiation session).

It should be noted from the above embodiments that the patient supportsystem 200 is advantageous in that it allows the patient 116 to betreated and imaged without moving the patient 116 from one patientsupport (e.g., a patient support associated with a treatment device) toanother patient support (e.g., a patient support associated with adiagnostic device). This in turn limits, or reduces the risk of,misalignment of the patient 116, and/or misalignment of a target regionwithin the patient 116, relative to a treatment/diagnostic machine. Thepatient support system 200 is also advantageous because it saves setuptime.

Also, in some embodiments, the radiation system 10 may have imagingcapability. For example, an imager may be placed opposite the source 40.Moreover, one or more diagnostic x-ray sources and imager(s) oppositethe source(s) may be provided. In some embodiments, one or more of thediagnostic sources and one or more imagers may be disposed in the sameplane as the treatment source 40. Such image data can be obtained for atleast a portion (e.g., a target region) of the patient 116 while thepatient 116 is at the first operative position. For example, before orafter a treatment session, or in between treatment radiation deliverysessions, the radiation system 10 can deliver radiation energy to imagea target region of the patient 116. The obtained image data can be usedto verify a position, an orientation, and/or a shape, of the targetregion, and/or to evaluate an effect of a treatment session. In anyembodiment, image data obtained using the imaging capability of system10 can be processed with image data obtained using one or more of thedevice 166, and/or one or more images from a previous diagnostic orplanning session, for treatment evaluation, treatment planning, and/orpatient positioning.

FIG. 9 illustrates the patient support system 200 of FIG. 7 inaccordance with some embodiments. The patient support system 200 can beused with any of the embodiments of the radiation system 10 describedherein, or with any radiation system, such as a treatment device or adiagnostic device. In some embodiments, the positioner 208 includes anactuator 240, a cylinder 242 coupled to the actuator 240, and a set ofsupports 244, 246, wherein the patient support 201 is slidably coupledto the supports 244, 246. In other embodiments, the supports 244, 246are part of the patient support 201, in which cases, the positioner 208does not include the supports 244, 246. During use, the actuator 240delivers hydraulic pressure to activate the cylinder 242, which in turn,causes the patient support 201 to translate in a first directionindicated by arrow 248. The actuator 240 can also remove hydraulicpressure to activate the cylinder 242, which in turn, causes the patientsupport 201 to translate in a second direction indicated by arrow 250.The supports 244, 246 provides vertical support for the patient support201 as the patient support 201 is being positioned by the actuator 240.In some embodiments, the supports 244, 246 are rails, and the patientsupport 201 includes a set of protrusions (e.g., wheels) that mate withthe respective rails. Such configuration allows the patient support 201to be guided in a desired manner as the patient support 201 is beingpositioned by the actuator 240.

It should be noted that the patient support system 200 should not belimited to the example discussed previously, and that the patientsupport system 200 can have other configurations in other embodiments.For example, in other embodiments, instead of the hydraulic pressureactuating cylinder 242, the positioner 208 can include a motor, such asan electric motor, a pneumatic motor, or a piezoelectric motor, forpositioning the patient support 201. In some embodiments, the motorcouples to a screw shaft and causes the screw shaft to turn. The screwshaft is coupled to the patient support 201, which positions the patientsupport 201 by rotation of the screw shaft. Also, in other embodiments,the supports 244, 246 can have configurations that are different fromthat shown in the figure. For example, instead of the bottom side of thepatient support 201, the supports 244, 246 can be coupled to the topside of the patient support 201 or to side edges of the patient support201. In other embodiments, the positioner 208 can be implemented usingmachineries, devices, and systems that are known in the art ofpositioning devices.

In the above embodiments, the patient support system 200 is configuredto translate linearly substantially along the axis 46 of the radiationsystem 10. In other embodiments, the patient support system 200 can alsohave other degrees of freedom. FIG. 10A illustrates the patient supportsystem 200 having multiple degrees of freedom in accordance with someembodiments. The patient support system 200 can be used with any of theembodiments of the radiation system 10 described herein, or with anyradiation system, such as a treatment device or a diagnostic device. Inthe illustrated embodiments, the positioner 208 includes a first baseportion 300, a second base portion 302 that is rotatably coupled to thefirst base portion 300, a first actuator 304 for turning a shaft 306, asecond actuator 308 for rotating a third actuator 310, the thirdactuator 310, a cylinder 312 coupled to the third actuator 310, and aset of supports 314, 316. The first actuator 304 can be, for example, amotor, that rotates the shaft 306, thereby causing the patient support201 to roll or rotate about a first axis 324. The second actuator 308can be, for example, a motor, that causes rotation of the third actuator310 about a second axis 326, thereby creating an inclined angle or pitchfor the patient support 201. The third actuator 310 is configured toactuate the cylinder 312, thereby causing the patient support 201 totranslate in directions 248, 250, as similarly discussed previously withreference to FIG. 9. In some embodiments, the positioner 208 can furtherinclude a fourth actuator (not shown) for causing the second baseportion 302 to rotate relative to the first base portion 300 about athird axis 328. Also, in other embodiments, the positioner 208 canfurther include an actuator for translating the patient support 201 inthe directions 329 a, 329 b. In further embodiments, the positioner 208can further include an actuator for changing an elevation of the patientsupport 201 (e.g., moving the patient support 201 in either of thedirections 341, 342). In some embodiments, such feature may be desirableif the bore 22 of the radiation system 10 is offset (e.g., higher orlower) than the bore of the adjacent device (e.g., bore 160 of thedevice in FIG. 2). In such cases, after the patient has been treated atthe first operative position associated with the structure 12, thepatient will be moved to the second operative position associated withthe adjacent device by translating the patient support longitudinallyand raising (or lowering) the patient support. This will ensure that thepatient support is located at a desired elevation relative to the secondbore. The various actuators described herein can be implemented usingmachineries, devices, and systems that are known in the art ofpositioning devices. The axes described herein can be positioned indifferent locations than those shown herein as desired.

Providing multiple degrees of freedom for the patient support 201 isadvantageous in that it allows the patient 116 to be treated or imagedin different configurations, and allows matching of patient positionand/or orientation from session to session (e.g., from a first imagingsession to a second imaging session, from a first treatment session to asecond treatment session, and/or from a treatment session to an imagingsession, or vice versa). For example, in some embodiments, the patientsupport 201 can be rotated about the axis 324 to place the patient 116in a desired orientation before the radiation source 40 is used todeliver radiation to the patient 116. In other embodiments, the patientsupport 201 can be rotated about the axis 324 while the radiation source40 is delivering radiation to the patient 116. In some embodiments, therotation of the patient support 201 about the axis 324 can be used tocompensate for slippage of the radiation source 40 relative to thestructure 12. In other embodiments, the patient support 201 can berotated about the axis 324 in accordance with a treatment plan tothereby allow a target region of the patient 116 to be treated fromdifferent angles. Providing for pitch (e.g. rotation about axis 326)and/or yaw (e.g. rotation about axis 328) type motions allow forproviding non coplanar fields. In further embodiments, the positioning(in any or a combination of the degrees of freedom described herein)provided by any of the embodiments of the patient positioning system 200may be used to execute and/or update a treatment plan. For example,instead of or in addition to modifying a gantry angle, a position of thepatient in one or more axes may be modified based on images of thepatient.

As shown in the figure, the patient support system 200 has a cantileverconfiguration. To eliminate, or at least reduce, the effect of tippingdue to the cantilever configuration, the patient support system 200further includes a weight 322 secured to the second base portion 302. Inother embodiments, the patient support system 200 does not include theweight 322. For example, if the first actuator 304 is made sufficientlyheavy to prevent tipping of the patient support 201, then the weight 322is not needed. Also, in other embodiments, instead of the cantileverconfiguration shown, the patient support system 200 can have otherconfigurations, such as a simply-supported configuration, which includesan additional support (not shown) for supporting the first end 202 ofthe patient support 201. In further embodiments, the patient supportsystem 200 is secured to a floor, a platform, or a structure, such as arotatable platform. Rotatable platform will be described later withreference to FIGS. 13A and 13B.

In the illustrated embodiments, the patient support system 200 furtherincludes a docking device 317 which allows the patient support system200 to be docked into a desired position. In some embodiments, thedocking device 317 includes a first set of rollers 318 on a first sideof the first base portion 300, and a second set of rollers 320 on asecond side of the first base portion 300. In other embodiments, thedocking device 317 can have less than two (e.g., one) set of rollers, ormore than two sets of rollers. Also, in other embodiments, the dockingdevice 317 can have less than two rollers 318/322 or more than tworollers 318/322 per set. Alternatively, any technique or device formoving the patient support 200, including any of those described inconjunction with moving device 166 described earlier, may be used.

FIG. 10B illustrates a top view of an environment in which the patientsupport system 200 of FIG. 10A can be used. As shown in FIG. 10B, threesets 330 a-330 c of rails are provided adjacent to the radiation system10. The first rail set 330 a includes first and second rails 332 a, 332b, the second rail set 330 b includes first and second rails 332 c, 332d, and the third rail set 330 c includes first and second rails 332 e,332 f. The rails 332 a, 332 b of the first set 330 a are configured(e.g., sized and shaped) to mate with the sets 318, 320 of rollers,respectively. The rails 332 c, 332 d of the second set 330 b areconfigured (e.g., sized and shaped) to mate with the sets 318, 320 ofrollers, respectively. The rails 332 e, 332 f of the third set 330 c areconfigured (e.g., sized and shaped) to mate with the sets 318, 320 ofrollers, respectively. In other embodiments, instead of having threesets 330 a-330 c of rails 332. Less than three sets (e.g., one set), ormore than three sets of rails can be provided. Also, in otherembodiments, instead of having two rails 332 per set 330, each set 330can have less than two rails 332 or more than two rails 332.

In some embodiments, the position of one or both of the sets 318, 320 ofrollers of the patient support system 200 can be adjusted such that thepatient support system 200 can be mated with rails having differentconfigurations. For example, in some embodiments, the distance betweenthe sets 318, 320 of rollers can be varied such that the patient supportsystem 200 can be docked with rails having different spacing. Also, inother embodiments, one or more rollers can be removed or added to thepatient support system 200 for allowing the patient support system 200to dock with a rail system having different number of rails. In someembodiments, the docking system 317 of the patient support system 200can further include the rails 332.

In other embodiments, the position of one or both of the rails 332 ineach rail set 330 can be adjusted such that the rail system canaccommodate different patient support systems having differentconfigurations. For example, in some embodiments, the distance betweenthe rails 332 in each set 330 can be varied such that patient supportsystems 200 having different roller spacing can be docked. Also, inother embodiments, one or more rails can be removed or added forallowing patient support systems 200 having different number of rollersto be docked.

It should be noted that the docking device 317 of the patient supportsystem 200 should not be limited to the examples discussed previously,and that the docking device 317 can have other configurations in otherembodiments. For example, in some embodiments, the docking device 317can have a first portion associated with the patient support system 200,and a second portion associated with the radiation system 10, whereinthe first portion and/or the second portion are configured to mate witheach other. The first and second portions of the docking device 317 canbe implemented using any machinery, device, or system known in the art.As such, the docking device 317 of the patient support system 200 may ormay not include rollers, and may or may not include rails 332. Infurther embodiments, any of the features or components described withreference to FIGS. 4 and 5 may be used to implement the docking device317.

In one method of use, the patient support system 200 of FIG. 10A can bedocked into a desired position relative to the radiation system 10 usingthe first set 330 a of rails 332 a, 332 b (FIG. 1C). As shown in FIG.10C, a longitudinal axis 340 of the patient support 201 is substantiallyparallel (e.g., within a prescribed range of angles, such as between 0°to 20°) with the axis 46 of the bore 22 of the radiation system 10. Insuch configuration, at least part of the patient support 201 can bepositioned through the bore 22. In another method of use, the patientsupport system 200 of FIG. 10A can be docked into a desired positionrelative to the radiation system 10 using the second set 330 b of rails332 c, 332 d (FIG. 10D). When docked using the second set 330 b of rails332 c, 332 d, the longitudinal axis 340 of the patient support 201 issubstantially non-parallel (e.g., forming an angle that is larger than aprescribed value, such as, 5°) with the axis 46 of the bore 22 of theradiation system 10. Such configuration allows the patient 116 supportedon the patient support 201 to be treated in a non-coplanar manner. Inyet another method of use, the patient support system 200 of FIG. 10Acan be docked into a desired position relative to the radiation system10 using the third set 330 c of rails 332 e, 332 f (FIG. 10E). Suchconfiguration allows the patient 116 supported on the patient support201 to be treated in another non-coplanar manner. In yet another methodof use, the patient support system 200 of FIG. 10A can be docked next tothe radiation system 10 in a side-by-side manner using a fourth set 330d of rails (FIG. 10F). Such configuration allows the patient 116supported on the patient support 201 to be treated in anothernon-coplanar manner. In some cases, for any of the configurations ofFIGS. 10C-10E, the position and/or orientation of the patient support201 can be further adjusted (e.g., by translating and/or rotating thepatient support 201) after the patient support system 200 is docked.

In other embodiments, instead of, or in addition to, having the railsets 330 adjacent to the first side 14 of the radiation system 10, oneor more rail sets can be provided adjacent to the second side 16 of theradiation system 10. Such configuration allows the patient supportsystem 200 to be docked adjacent to the second side 16 of the radiationsystem 10, thereby allowing the patient support 201 to be inserted intothe bore 22 of the radiation system 10 from the second side 16 of theradiation system 10. For example, in other embodiments, the device 166can be first docked next to the radiation system 10. The patient supportsystem 200 is then docked next to the device 166, thereby allowing thepatient support 201 to be inserted into the bore 22 of the radiationsystem 10 through at least a portion of the device 166.

In other embodiments, instead of providing multiple sets of rails, asingle set of rail(s) may be provided for allowing the patient supportsystem 200 to be placed at different positions relative to the radiationsystem 10. FIG. 10G illustrates a set 330 e of rails 332 g, 332 h thatare positioned next to the radiation system 10. Each of the rails 332 g,332 h has an arc shape, which allows the patient support system 200 tobe slid in a curvilinear manner around the radiation system 10. This inturn allows the patient support system 200 to be placed at differentpositions relative to the radiation system 10. In other embodiments, therail set 330 e can have more than two rails or less than two rails(e.g., one rail). In some embodiments, the patient support system 200 isdetachably coupled to the rail set 330 (e.g., the patient support system200 can include a docking system for allowing the patient support system200 to be docked against the rail set 330).

In further embodiments, the rail set 330 e can have differentconfigurations. For example, as shown in FIG. 10H, the rail set 330 ecan have an arc shape that allows the patient support system 200 to bepositioned from one side of the structure 12 (e.g., at the firstoperative position associated with the radiation source 40), to anotherside of the structure 12 (e.g., at the second operative positionassociated with the device 166). In alternative embodiments, the railset 330 e can have a ring configuration that loops substantially aroundthe radiation system 10 and the device 166. In the embodiment of FIG.10H, the patient support surface may be carried along with the otherportions of the patient support system 200. Alternatively, the patientsupport surface may temporarily be engaged with system 10 and/or system12, as will be described in more detail below, and a portion of thepatient support system 200 without the support surface may travel alongthe rail set 330 e and access the support surface from either side.

It should be noted that the patient support system 200 of FIG. 10Ashould not be limited to the examples described previously, and that thepatient support system 200 can have different configurations in otherembodiments. In other embodiments, the patient support 201 does not havesome, a combination, or all, of the degree of freedom describedpreviously. For example, in some embodiments, the positioner 208 doesnot include the first actuator 304, the second actuator 308, or both.Also, in other embodiments, the relative positions of the actuators 304,308, 310 can be different from that shown in the figure. Further, inother embodiments, the patient support system 200 does not include thedocking device 317. In such cases, the patient support system 200 can befixedly secured to a floor.

In other embodiments, instead of using the patient support system 200with the radiation system 10 and the device 166 (e.g., the device 100)having the configuration shown in FIG. 6 (which shows the structure 12and the device 166 being in a front-to-back or front-to-frontconfiguration), any of the embodiments of the patient support system 200described herein can be used with the radiation system 10 and the device166 having other configurations. FIGS. 11A and 11B illustrate theradiation system 10 of FIG. 1, and the device 166, wherein the device166 is placed closer to the first side 14 than the second side 16 of thestructure 12 in a front-to-front configuration. The device 166 isillustrated as the CT device, but can be any of the diagnostic/treatmentdevices described herein. In such cases, any of the embodiments of thepatient support system 200 described herein can be placed between theradiation system 10 and the device 166. During use, the patient supportsystem 200 positions the patient support 201 at the first operativeposition associated such that the radiation source 40 can be used todeliver the radiation beam 42 to treat the patient 116 (FIG. 11A). If itis desired that the patient 116 be imaged, for example, the patientsupport 201 is first translated to remove the patient support 201 out ofthe bore 22 of the radiation system 10. The second base portion 302 ofthe patient support system 200 is then rotated relative to the firstbase portion 300 about the axis 328, until the patient support 201 iscloser to the device 166 than the radiation system 10. The patientsupport 201 is then translated axially until the patient support 201 islocated at the second operative position at which the patient 116 can beoperated by the device 166 (FIG. 11B). The above described operation ofthe patient support system 200 can be reversed if it is desired to movethe patient support 201 from the second operative position associatedwith the device 166 to the first operative position associated with theradiation source 40.

In other embodiments, instead of using the patient support system 200 inan environment in which the radiation system 10 and the device 166 areplaced in a front-to-front manner (such as that shown in FIG. 1A), thepatient support system 200 can be placed between the radiation system 10and the device 166 that are placed in a back-to-back manner. Also, inother embodiments, instead of the radiation system 10 and/or the device166 described herein, any of the embodiments of the patient supportsystem 200 can be used with other treatment machine and/or diagnosticmachine. For example, in some embodiments, the patient support system200 can be placed between a radiation treatment machine having aconfiguration that is different from that shown in FIG. 1, and adiagnostic machine, such as an imaging device.

FIGS. 12A-12C illustrate a patient support system 400 in accordance withother embodiments. The support system 400 includes a first positioner402, a second positioner 404, and a patient support 406. The firstpositioner 402 is located adjacent to the radiation system 10, and thesecond positioner 404 is located adjacent to the device 166. The patientsupport 406 has a first end 407 and a second end 409.

The first positioner 402 includes an actuator 408, a coupler 410 that isused to detachably secure the patient support 406 to the positioner 402,and a support system 412 coupled to the patient support 406 and theactuator 408. The actuator 408 can be a motor, a hydraulic mechanism, orother mechanism, and is configured to position the patient support 406along the axis 46 of the bore 22. As the patient support 406 is beingpositioned by the actuator 408, the support system 412 providesstructural support for the patient support 406. In some embodiments, thesupport system 412 includes a pair of supports, such as the supports244, 246 discussed previously with reference to FIG. 9. Alternatively,the support system 412 can have other configurations (e.g., having aplatform). In the illustrated embodiments, the coupler 410 includes ajaw assembly 414 having a first jaw 416 and a second jaw 418, and isconfigured to engage with the first end 407 of the patient support 406.As shown in FIG. 12A, the jaw assembly 414 is in a closed position,thereby detachably coupling the patient support 406 to the firstpositioner 402. In other embodiments, instead of the jaw assembly 414,the coupler 410 can have other configurations that allow the coupler 410to detachably secure to a portion of the patient support 406. Forexample, in other embodiments, the coupler 410 can include one or moredowels or protrusions that are sized to be inserted in respectiveslot(s) at the patient support 406. The dowel(s) or protrusion(s) may beused to provide moment resistance resulted from the patient 116 beingsupported on the patient support 406. The coupler 410 may furtherinclude a locking mechanism for securing to the patient support 406after the dowel(s) or protrusion(s) have been inserted into respectiveslot(s). In further embodiments, the coupler 410 may have other types ofsecuring mechanisms for detachably coupling to the patient support 406.Also, in alternative embodiments, instead of the first end 407, thecoupler 410 can engage with other portion(s) of the patient support 406.

In some embodiments, the second positioner 404 may be similar to thefirst positioner 402, and includes an actuator 420, a coupler 424 thatis used to detachably secure the patient support 406 to the secondpositioner 404, and a support system 426 coupled to the patient support406 and the actuator 420. The actuator 420 can be a motor, a hydraulicmechanism, or other mechanism, and is configured to position the patientsupport 406 along the axis 160 of the lumen 122. As the patient support406 is being positioned by the actuator 420, the support system 426provides structural support for the patient support 406. In someembodiments, the support system 426 includes a pair of supports, such asthe supports 244, 246 discussed previously with reference to FIG. 9.Alternatively, the support system 426 can have other configurations. Thecoupler 424 includes a jaw assembly 428 having a first jaw 430 and asecond jaw 432, and is configured to engage with the second end 409 ofthe patient support 406. In other embodiments, instead of the jawassembly 428, the coupler 424 can have other configurations that allowthe coupler 424 to detachably secure to a portion of the patient support406. Also, in alternative embodiments, instead of the second end 409,the coupler 424 can engage with other portion(s) of the patient support406.

In other embodiments, the second positioner 404 can have a configurationthat is different from the first positioner 402. For example, in otherembodiments, the second positioner 404 can have number of degrees offreedom, and/or degrees of freedom, that are different from those of thefirst positioner 402.

The patient support system 400 can be used to position the patient 116at a first operative position (e.g., the position of the patient116/patient support 406 at which the patient 116 can be treated by theradiation source 40), and at a second operative position (e.g., theposition of the patient 116/patient support 406 at which the patient 116can be operated by the device 166). For example, as shown in FIG. 12A,the coupler 410 can engage with the patient support 406 to thereby allowthe actuator 408 to control a position of the patient support 406. Insome embodiments, the actuator 408 is coupled to a processor (such asany of the processors described herein), which controls an operation ofthe actuator 408. For example, the processor 84/134 can provide signalsto the actuator 408 to cause the actuator 408 to position the patientsupport 406 along the axis 46 during, or in between, radiation deliverysessions.

If it is desired to place the patient 116 at the second operativeposition, the actuator 408 then advances the patient support 406 furtherinto the bore 22 until the second end 409 of the patient support 406 isengaged with the coupler 424 of the second positioner 404 (FIG. 12B).When the coupler 424 is engaged with the second end 409, the jaws 430,432 of the jaw assembly 428 are closed to grab onto the second end 409of the patient support 406. After the coupler 424 is engaged with thepatient support 406, the coupler 410 of the first positioner 402 is thendisengaged (e.g., by opening the jaw assembly 414) with the first side407 of the patient support 406 (FIG. 12C). The patient support 406 canthen be positioned by the second positioner 404 until the patientsupport 406 is at the second operative position. During use of thedevice 166, the second positioner 404 can be used to position thepatient support 406 along the axis 160 associated with the device 166.

In other embodiments, the patient support system 400 can haveconfigurations that are different from those described previously. Forexample, in other embodiments, the patient support system 400 caninclude other types of mechanical devices or systems that allow thepatient support 406 to be passed from one positioner to anotherpositioner. Also, in other embodiments, the radiation system 10 and/orthe device 166 can have a mechanical component that temporarily engagesthe patient support 406 before the patient support is passed from afirst positioner to a second positioner. In such cases, the firstpositioner may or may not engage with the patient support 406 while theradiation system 10 and/or the device 166 is engaged with the patientsupport 406. In some embodiments, a single positioner can be used suchthat after the system 10 and/or system 166 has engaged the patientsupport 406, the positioner is moved to the opposite side to engage thepatient support 406 from that side.

In further embodiments, the radiation system 10 or the device 166 caninclude a positioner for positioning the patient support 406. In suchcases, the patient support system 400 does not include the positioner404 (or the positioner 402), and the positioner 402 (or the positioner404) can be used to position the patient support 406 through a firstrange of positions, and pass the patient support 406 to the positionerof the radiation system 10 or the device 166, which can be used toposition the patient support 406 through a second range of positions.The first range of positions and the second range of positions may ormay not overlap.

In any of the embodiments of the patient support system 200/400described herein, the positioner 208 (or positioner 402 or 404) can becoupled to a computer system or a processor, such as the processor 84 ofFIG. 1A, the processor 134 of FIG. 2, or a separate processor. Theprocessor can then be used to control an operation of the positioner208. For example, the processor may be configured (e.g., programmedand/or constructed) to control an amount of movement of the patientsupport (e.g., rotation about axis 324 to thereby tilt the patientsupport, and/or other types of movement described herein) during aprocedure. In some embodiments, the amount of movement of the patientsupport is prescribed by a treatment plan, which is executed by theprocessor during a treatment session. The treatment plan may be one thatis determined during a diagnostic session, or alternatively, be one thatis determined during a treatment session (for example, the treatmentplan determined in a diagnostic session may be modified during atreatment session to result in a modified treatment plan).

In some embodiments, the patient support system 200 can further includeone or more position/motion sensors for sensing a position/motion of thepatient support 201. The sensed position/motion is then transmitted fromthe sensor(s) to the processor, which determines an actual position ofthe patient support 201 based on the sensed position/motion receivedfrom the sensor(s). In some cases, the processor can be furtherconfigured to position the patient support 201 based on the actualposition of the patient support 201 (e.g., having a feedback feature).

Also, in any of the embodiments of the patient support system 200/400described herein, the patient support system 200/400 can further includeone or more markings (not shown), which allows the patient support201/406 to be registered with the radiation system 10 and/or With thedevice 166. For example, one or both of the radiation system 10 and thedevice 166 can include an optical sensor for sensing the marking(s) ofthe patient support system 200/400, thereby allowing a position of thepatient support 201 to be determined. The optical sensor can be, forexample, a camera or an infrared position sensor. In some embodiments,the optical sensor is coupled to the processor, which receives positionsignals from the optical sensor. Based on the received position signals,the processor then determines an actual position of the patient support201.

It should be noted that the patient support system 200/400 can haveother configurations in other embodiments. For example, in otherembodiments, the patient support system 200 can have the configurationshown in FIG. 13A. The patient support system 200 of FIG. 13A includesthe patient support 201, a patient positioner 208, a first base portion300, and a second base portion 302 that is rotatably coupled to thefirst base portion 300. In the illustrated embodiments, the first baseportion 300 is coupled (e.g., fixedly secured, or detachably secured) toa platform 262, which is rotatably secured to a floor (or a platform).The platform 262 can rotate about a vertical axis 350 in the directionsshown by the double-headed arrow 360 a. The second base portion 302 isrotatably coupled to the first base portion 301 such that the secondbase portion 302 is rotatable about vertical axis 352 in the directionsshown by the arrow 360 b. In other embodiments, first base portion 300and the platform 262 can be implemented as a single unit or structure.

The positioner 208 includes a first arm 366 rotatably secured to thesecond base portion 302 such that the first arm 366 is rotatablerelative to the second base portion 302 in the directions shown by thearrow 360 c. The positioner 208 also includes a second arm 368 that isrotatably secured to the first arm 366 such that the second arm 368 isrotatable relative to the first arm 366 in the directions shown by thearrow 360 d. The patient support 201 is slidably secured to a support370, which in turn, is rotatably secured to the second arm 368. As such,the patient support 201 is rotatable relative to the second arm 368 inthe directions shown by the arrow 360 e, and is slidable relative to thesupport 370 as indicated by the arrow 360 f.

During use, the platform 262 can be rotated to place the patient support201 at a desired position relative to the radiation system 10. Also, insome cases, the second base portion 302 can be rotated relative to thefirst base portion 300 to place the patient support 201 at a desiredposition relative to the radiation system 10 (FIG. 13B). As illustrated,the combination of rotating the first base portion 300 about the axis350, and rotating the second base portion 302 about the axis 352 (and insome cases, further coupled with translation movement 360 f of thepatient support 201) allows the patient support 201 to be oriented at adesired angle 390 relative to the radiation system 10, and be placed inan operative position associated with the radiation system 10 (FIG.13C). For example, in some cases, after the patient support 201 has beenpositioned such that a point 380 on the patient support 201 is locatedat a desired location, the movements of the base portions 300, 302 (andin some cases, together with translation of the patient support 201) mayallow the patient support 201 to be rotated about a vertical axis 384through the point 380 (as indicated by the arrow 382) to thereby adjustan orientation of the patient support 201 relative to the system 10.Also, in some cases, movements of the arms 366, 368 allows a height(elevation) of the patient support 201 to be adjusted. Further, thepatient support 201 may rotate relative to the second arm 368 as thesecond arm 368 rotates relative to the first arm 366 to thereby remainin a horizontal configuration. The patient support 201 may rotaterelative to the second arm 368 while the second arm 368 remainsstationary relative to the first arm 366. In such cases, the movement ofthe patient support 201 allows an angle of tilt of the patient support201 to be adjusted.

In other embodiments, the patient support 201 of the patient supportsystem 200 may be configured so that it does not translate relative tothe arm 368. Also, in further embodiments, the patient support 201 mayhave other degrees of freedom, such as any or combination of the degreesof freedom described with reference to FIG. 1A. For example, in otherembodiments, the patient support 201 may have a roll feature in whichthe patient support 201 may tilt or rotate about a longitudinal axis 324of the patient support 201.

Although the patient support system 200 of FIGS. 13A and 13B isillustrated as being used with the radiation system 10 with the arm 30,in other embodiments, the patient support system 200 of FIGS. 13A and13B may be used with any of the radiation systems 10 described herein(e.g., the radiation system 10 of FIG. 1F that does not include the arm30), with any of the devices 166 described herein, and/or with anyradiation system not described herein (which may be a treatment machineor a diagnostic machine).

In any of the embodiments of the patient support system 200/400described herein, the patient support 201/406 can have a feature thatallows a surface of the patient support 201 to be customized fordifferent patients. FIG. 13D illustrates a variation of the patientsupport 201 in accordance with some embodiments. The patient support 201includes a plurality of support portions 270 a-270 j that arepositionable relative to each other, thereby allowing a desired supportsurface to be formed. In the illustrated embodiments, support portions270 a-270 j are adapted to support a head, left arm, right arm, upperbody, mid-body, lower body, left side of a body, right side of a body,thighs, and legs, respectively, of a patient. In some cases, the supportportion 270 d can be rotated relative to the support portion 270 f (asindicated by arrow 274 d) to form a convenient position and shape forloading and unloading a patient for treatment and/or imaging. Forexample, to facilitate patient loading, the patient support can forminto a shape of a chair onto which the patient sits. Thereafter, oncethe patient is in the chair (and positioned and/or immobilized ifdesired), the patient support forms into a position and/or moves into alocation as needed for treatment and/or imaging.

As shown in the embodiments of FIG. 13D, support portion 270 a maytranslate relative to support portion 270 d (as indicated by arrow 274b) to accommodate patients with different neck lengths, and may rotaterelative to support portion 270 d (as indicated by arrow 274 a) toadjust an angle of tilt of a patient's head. The support portion 270 dmay also translate relative to support portion 270 e (as indicated byarrow 274 c) to adjust for patients with different body lengths. Thesupport portions 270 g, 270 h may rotate (as indicated by arrows 274 e)and translate (as indicated by arrows 274 f) to hold a patient's body inplace and to adjust for patients with different body widths. The supportportion 270 i may rotate relative to the support portion 270 f to adjustan angle of tile of a patient's thighs. The support portion 270 j mayrotate relative to the support portion 270 i to adjust an angle of tileof a patient's legs. The support portions 270 b, 270 c may rotate (asindicated by arrows 274 j), may locally translate (as indicated byarrows 274I), and/or may globally translate (as indicated by arrows 274k) to adjust for different arms positions of the patient. In otherembodiments, not all of the support portions 270 of the patient support201 are moveable as described, and any or a subset of the supportportions 270 may be fixed relative to an adjacent support portion. Also,in further embodiments, any of the support portions 270 may haveadditional degree of movement(s). For example, in other embodiments, thesupport portion 270 i may translate relative to the support portion 270f to adjust for patients with different thigh lengths.

In some embodiments, the patient support 201/406 can further includedevice(s) for knowing and setting position for each of the supportedportions, such as position sensors secured to each of the supportportions 270 a-270 j. In such cases, a memory can be used to storeposition signals from the position sensors, which represent a desiredsupport configuration of the patient support 201 for a specific user.The memory can store different sets of position signals for differentusers. Also, a user interface, such as a computer, or a set of buttons,can be used to allow a user to select a desired set of position signalsfrom the memory. In some embodiments, the positioner 208 automaticallyadjusts the support portions 270 a-270 j based on the selected set ofposition signals, thereby placing the support portions 270 a-270 j in aconfiguration that was previously selected by a user.

In any of the embodiments described herein, the patient support 201/406can include a matrix of support portions 276 (FIG. 13E). Each of thesupport portions 276 can be positioned by a positioner 272 to move inthe directions shown by the double headed arrow 271. Such configurationallows the patient support 201 to provide different configurations ofthe support surface for different users. The positioner 272 may beactuated using a motor, a hydraulic, a pneumatic device, or any of othertypes of mechanical linkage. In some embodiments, the patient support201 of FIG. 13E can further include device(s) for sensing position, suchas position sensors, and a memory for storing set positions, assimilarly discussed previously. The matrix of support portions 276 maybe implemented in any of the embodiments of the patient support 201/406described herein. For example, in some embodiments, any of the supportportions 270 in FIG. 13D may be substituted with, or may include, amatrix of the support portions 276. In other embodiments, the matrix ofthe support portions 276 may be implemented in other embodiments of thepatient support 201/406, or in a patient support not described herein.

In any of the embodiments of the radiation system 10 described herein,the radiation system 10 can further include a patient position sensingsystem 440 (FIG. 14A). The patient position sensing system 440 includesan optical device 441 a and a marker block 442. In the illustratedembodiments, the optical device 441 a is a camera, such as a CCD camera,but can be other type of optical sensor that is capable of sensing anobject. The optical device 441 a can be mounted to a ceiling, to theradiation system 10 (e.g., within the bore 22), to the device 166, tothe patient support system 200 (e.g., the patient support 201) (FIG.14C), or to a support stand (not shown). The marker block 442 includes aplurality of markers 444 that are so positioned such that at least someof them can be viewed/sensed by the optical device 441 a. The markers444 can be implemented using reflective objects. In the illustratedembodiments, the optical device 441 a is coupled to the processor 134,which controls an operation of the radiation system 10 based on inputreceived from the optical device 441 a. Alternatively, the opticaldevice 441 can be coupled to the processor 84 of FIG. 1A, or a separateprocessor, for processing image signals received from the optical device441 a.

During use, the marker block 442 is secured to the patient 116, and theoptical device 441 a is used to sense the positions of at least some ofthe markers 444 on the marker block 442. Based on the sensed positionsof at least some of the markers 444, the processor 134 then determines aposition and an orientation of the marker block 442. The determinedposition and orientation of the marker block 442 can then be used todetermine whether the patient 116 has moved and/or an amount of movementundergone by the patient 116. In such cases, the processor 134 can beconfigured to control an operation (e.g., a rotational speed of theradiation source 40 about the patient 116, an activation of theradiation source 40, a de-activation of the radiation source 40, anactivation period of the radiation source 40 (duration of radiationdelivery), etc.) of the radiation system 10 based on the determinedpatient movement. In some embodiments, the patient movement isassociated with a respiration of the patient 116. In such cases, theprocessor 134 can be configured to control an operation of the radiationsystem 10 based on phase(s) of the respiratory cycle of the patient 116.In other embodiments, the processor 134 can be configured to control anoperation of the radiation system 10 based on other physiologicalmovements of the patient 116.

In some embodiments, the processor 134 can be configured to gate anoperation of the radiation system 10 based on the determined patientmovement. For example, in some embodiments, the processor 134 isconfigured to activate the radiation source 40 when an amplitude of thepatient movement is below a prescribed threshold, and de-activate theradiation source 40 when an amplitude of the patient movement is above aprescribed threshold. In another example, the processor 134 isconfigured to activate the radiation source 40 during a certainprescribed phase(s) of the patient movement (e.g., respiratorymovement/cycle), and de-activate the radiation source 40 during anotherprescribed phase(s) of the patient movement. As used in thisspecification, the term “phase” refers to a variable that is associatedwith a degree of completeness of a physiological cycle (e.g., arespiratory cycle). Patient position sensing systems, methods ofperforming medical procedures based on sensed physiological movement,and methods of gating an operation of a radiation device have beendescribed in U.S. patent application Ser. Nos. 09/178,383,09/893,122,10/664,534, 10/454,754,10/234,658, 10/305,416, 10/656,478,and 10/655,920, all of which are expressly incorporated by referenceherein.

It should be noted that the patient position sensing system 440 shouldnot be limited by the configuration described previously, and that thepatient position sensing system 440 can have other configurations inother embodiments. For example, in other embodiments, instead of asingle optical device 441 a, the patient position sensing system 440 canfurther include one or more additional optical device(s) 441 for sensingthe marker block 442 when the patient 116 is located at the firstoperative position associated with the radiation source 40. Also, inother embodiments, the patient position sensing system 440 can furtherinclude one or more marker block(s) 442. In further embodiments, insteadof having a cube configuration, the marker block 442 can have othershapes, such as a semi-spherical shape, a cone shape, or othercustomized shapes.

In other embodiments, instead of, or in addition to, having the opticaldevice 441 a for sensing patient movement when the patient 116 is beingoperated by the radiation source 40, the radiation system 10 can have asecond optical device 441 b for sensing patient movement when thepatient 116 is being operated by the device 166 (illustrated as a blockdiagram) (FIG. 14B). In such cases, when the patient 116 is positionedat the second operative position associated with the device 166, theoptical device 441 b can be used to sense patient movement. The sensedpatient movement can then be used to control an operation of the device166, as similarly discussed previously.

In some embodiments, if the optical device 441 a is secured to thepatient support system 200 (such as that shown in FIG. 14C), then thesecond optical device 441 b is not needed. In such cases, the opticaldevice 441 b will be moved with the patient support 201, and the opticaldevice 441 can be used to sense the marker block 442 when the patient ispositioned at the first operative position associated with the radiationsource 40, and at the second operative position associated with thedevice 166. In other embodiments, the optical device 441 a may besecured at a distance that is sufficiently far away from the first andsecond operative positions such that it can view both positions in asingle field of view. In further embodiments, the optical device 441 amay be moveable (e.g., pivotable and/or translatable). For example, ifthe device 166 is positioned next to the structure 12 in a side-by-sideconfiguration, the optical device 441 a may be rotated towards a firstdirection associated with the structure 12 when the patient is beingoperated in the first operative position, and may be rotated towards asecond direction associated with the device 166 when the patient isbeing operated in the second operative position. Devices placed in aside-by-side configuration will be described in FIG. 17E.

In some embodiments, the device 166 is a CT device. In such cases, thesecond optical device 441 b is used to determine phases of aphysiological cycle as the CT device is used to generate a plurality ofimages at the plurality of phases of a physiological cycle, wherein eachof the images provides an indication of a location of a target region.The processor 134 then creates a treatment plan based at least in parton the plurality of images collected at the plurality of phases in thecycle. After the treatment plan has been created, the patient 116 isthen positioned from the second operative position associated with thedevice 166 to the first operative position associated with the radiationsource 40 (e.g., by being translated at least partially through the bore22 of the structure 12). The radiation source 40 is then used to treatthe patient 116 in accordance with the created treatment plan. In someembodiments, the created treatment plan prescribes the phases of aphysiological cycle at which radiation is to be delivered to the patient116, and the amount of radiation to be delivered at the prescribedphases. In such cases, the first optical device 441 a can be used todetermine patient movement when the patient 116 is at the firstoperative position, and the radiation source 40 is used to deliverradiation to the patient 116 based on the determined patient movement inconformance with the treatment plan.

In any of the embodiments described herein, instead of using the opticaldevice 441 to sense marker(s) on the marker block 442, the opticaldevice 441 may be used to sense a marker on a patient. For example, themarker may be a print made on a skin of the patient. Alternatively, themarker may be a part of an anatomy of the patient, such as a skin markon the patient, or a topography/shape of a portion of a patient.

Although the patient position sensing system 440 has been described ashaving the optical device 441 and the marker block 442, in otherembodiments, other position/movement sensing devices can be used as thepatient position sensing system 440. As such, the patient positionsensing system 440 may or may not include the optical device 441 and themarker block 442. For example, in other embodiments, the patientposition sensing system 440 includes one or more infrared positionsensors for sensing at least a part of the patient 116. In otherembodiments, the patient position sensing system 440 includes one ormore magnetic field sensors. In such cases, one or more magneticdevices, such as coils, may be placed within, or secured on, the patient116. An external electromagnetic coil then provides electromagneticpulses to interact with the coil(s) within/on the patient 116. Based onthe interaction, the position and/or the orientation of the patient 116can be determined. In alternative embodiments, the patient positionsensing system 440 includes one or more sensors, such as RF transponder,ultrasound sensors, or microwave energy sensors (which utilizestechnologies that are similar to those used in radar systems), forsensing at least a part of the patient 116. In other embodiments, thepatient position sensing system 440 includes one or more ultrasoundenergy sensors for sensing at least a part of the patient 116. Infurther embodiments, other devices, such as a strain gauge, or othermechanical/electrical devices, can be used to sense a position/movementof the patient 116.

In further embodiments, the patient position sensing system 440 may bean imaging device. The imaging device may be, for example, a CT device,a laminar tomography device, a MRI device, a fluoroscope, an angiographydevice, a PET device, a PET-CT device, a SPECT device, or atomosynthesis imaging device. In such cases, the imaging device may beused to obtain an image of a portion of the patient, and a processorthen processes the image to determine a position of a target tissue. Forexample, the processor may process the image to identify one or moremarkers implanted at or near a target tissue. Alternatively, theprocessor may process the image to identify a part of an anatomy of thepatient. In some embodiments, the device 166 may be the imaging devicethat is a part of the patient position sensing system 440.

It should be noted that the method of using the patient position sensingsystem 440 should not be limited to the examples discussed previously,and that the patient position sensing system 440 can be used to assistdetermining treatment plans and/or to assist gating of medicalprocedures in other manners in other embodiments. For example, in otherembodiments, the patient movement sensed by the first optical device 441a can be used in a predictive physiological gating procedure, in whichthe operation of the radiation source 40 is predictively gated based atleast in part on the patient movement. Predictive gating of a medicalprocedure has been described in U.S. patent application Ser. No.09/893,122.

Further, in some embodiments, the position sensing system 440 can beused to determine a position of the patient support 201. For example,the marker block 442 (or another marker block) can be secured to thepatient support, and the optical device 441 is then used to sense themarkers on the marker block. Based on the sensed markers, the processor134 then determines a position and an orientation of the marker block442 (and therefore, the position and orientation of the patient support201). In other embodiments, instead of using a marker block, the patientsupport 201 can include a detectable marker secured to a portion of thesupport 201.

In the above embodiments, the position sensing system 440 has beendescribed as having the marker block 442. However, in other embodiments,the marker block 442 is not needed, and the position sensing system 440does not include the marker block 442. For example, in some embodiments,the optical device 441 can be used to sense a portion of a patient,wherein the portion is used as a marker (e.g., a physiological marker).In such cases, a processor (such as the processor 84/134) can beconfigured to receive image signal from the optical device 441, andprocess the signal to identify the physiological marker. In someembodiments, the processor can be configured to identify and analyze atopography of a patient surface, and determine a characteristic of thepatient, such as an amplitude and/or a phase of a breathing cycle of thepatient based on a result of the analysis.

In any of the embodiments of the radiation system 10 described herein,the radiation system 10 can further include one or more compensatingcoils 450 that are electrically coupled to a generator 452 (FIG. 15). Inthe illustrated embodiments, the radiation system 10 includes a pair ofcoils 450 a, 450 b that are parallel to a x-axis of the radiation system10, a pair of coils 450 c, 450 d that are parallel to a y-axis of theradiation system 10, and four coils 450 e-450 h that are parallel to az-axis of the radiation system 10. In other embodiments, the number ofcoils 450 can be different from that shown. For example, in otherembodiments, the radiation system 10 can include one coil (e.g., coil450 a) that is parallel to the x-axis, one coil (e.g., coil 450 c) thatis parallel to the y-axis, and one coil (e.g., coil 450 e) that isparallel to the z-axis. Also, in alternative embodiments, the radiationsystem 10 can include fewer or more than three sets of coils 450, whicheach set having one or more coils 450. In further embodiments, theorientation and position of the coils 450 can be different from thatshown. For example, in other embodiments, the radiation system 10 caninclude coils 450 that are not orthogonal relative to each other. In theillustrated embodiments, the coils 450 are illustrated as being locatedwithin the structure 12. In other embodiments, instead of placing thecoils 450 inside the structure 12, some or all of the coils 450 can besecured within the arm 30 of the radiation system 10, the patientsupport system 200, the device 166, or a separate structure (not shown)that is adjacent to the radiation system 10.

One or more generator, such as generator 452 is configured toselectively provide electrical energy to one or more of the coils 450 tocreate a desired electromagnetic field having a certain magnitude duringan operation of the radiation system 10. In some embodiments, the device166 may include an electron accelerator that may remain on while theradiation source 40 is used to deliver radiation to the patient 116. Insuch cases, the electromagnetic field created by the coil(s) 450 is usedto compensate (e.g., reduce) interference associated with a magneticfield of the accelerator in the device 166. In other embodiments, amagnetic field of an accelerator in the radiation system 10 mayinterfere with an operation of the device 166 (especially if the device166 includes a radiation source). In such cases, the electromagneticfield created by the coil(s) 450 is used to compensate (e.g., reduce)interference resulted from a magnetic field of the accelerator in theradiation system 10. In other embodiments, the magnetic field created bythe coil(s) 450 can be used to compensate interference effects due toother components, such as a positioner of a patient support system.

In some embodiments, the generator 452 is coupled to a processor, suchas the processor 84 of FIG. 1A, which controls an operation of thegenerator 452. In other embodiments, instead of using the processor 84,the generator 452 can be coupled to the processor 134, or a separateprocessor, which controls an operation of the generator 452. Theprocessor 84/134 can be configured (e.g., programmed) to provideactivation signals to the generator 452 to cause the generator 452 toactivate certain coil(s) 450 during an operation of the radiation system10. In other embodiments, instead of, or in addition to, providingactivation signals, the processor 84/134 can be configured to determinean amount of current to be delivered to each of the coil(s) 450 to beactivated. In some embodiments, the magnetic field resulted from theaccelerator 31 can be calculated based on operational parameters of theaccelerator 31 (such as a position of the accelerator 31, an orientationof the accelerator 31, an/or an amount of current to be delivered to theaccelerator 31), and the processor then determines which of the coils450 to activate to eliminate, or at least reduce the effect of, themagnetic field associated with the accelerator 31. In other embodiments,instead of calculating the magnetic field associated with theaccelerator 31, one or more magnetic field sensors can be placedadjacent to the accelerator 31 (such as on or next to the device 166).In such cases, the processor receives signals from the magnetic fieldsensor(s), and determines which of the coils 450 to activate toeliminate, or at least reduce the effect of, the magnetic fieldassociated with the accelerator 31.

In the above embodiments, the compensating magnetic field is describedas being provided by one or more coils 450. Alternatively, instead of,or in addition to, using electromagnetic coils 450, the radiation system10 can include one or more permanent magnets that provides a magneticfield for compensating (at least in part) magnetic interference.

In any of the embodiments described herein, instead of, or in additionto, including compensating coil(s) and/or magnet(s), the radiationsystem 10 can further include a shield to prevent, or at least minimizethe effect of, interference due to the accelerator 31. For example, ashield (not shown) can be placed between the accelerator 31 and thedevice 166 to prevent, or at least minimize the effect of, interferencedue to the accelerator 31. The shield can be made from Mumetal, or othermaterials. In some embodiments, the shield can be placed around theaccelerator 31. In other embodiments, the shield can be placed aroundthe device 166 or a component (e.g., a component that may be affected bya magnetic field from the accelerator 31) of the device 166. In otherembodiments, the shield can be secured to the structure 12, such as tothe second side 16 of the structure 12. In any embodiment, the coilsand/or shield may be used to shield other devices from the a magneticfield such as that generated by the accelerator, such as a MRI device,or a magnetic based sensing device.

In any of the embodiments of the radiation system 10 described herein,the radiation system 10 can further include a protective guard 500 forprotecting the patient 116 (FIG. 16A). The guard 500 can be made fromany material, such as carbon fiber, as long as it allows at least someof the radiation from the radiation source 40 to be transmittedtherethrough. In the illustrated embodiments, the guard 500 has acircular cylindrical shape, but can have other cylindrical shapes inother embodiments. Also, in other embodiments, the guard 500 can be apartial cylinder (e.g., have an arc shape cross section) (FIG. 16B).

During use, the guard 500 is placed between the patient 116 and theradiation source 40 (FIG. 16C). The guard 500 protects the patient 116from being collided with the radiation source 40 or the arm 30 of theradiation system 10 as the radiation source 40 is rotating about thepatient 116. The guard 500 also allows the arm 30 (and therefore, theradiation source 40) to be rotated about the patient 116 at a fasterspeed without the risk of injuring the patient 116.

In some embodiments, the guard 500 is detachably coupled to theradiation system 10. In such cases, when the guard 500 is not used, theguard 500 can be detached from the radiation system 10. In otherembodiments, the guard 500 is detachably coupled to the patient supportsystem 200. In such cases, when the guard 500 is not used, the guard 500can be detached from the patient support system 200. In otherembodiments, the guard 500 is rotatably secured (e.g., via one or morehinges) to the radiation system 10, which allows the guard 500 to beopened or closed relative to the radiation system 10 between uses. Infurther embodiments, the guard 500 is slidably secured to the radiationsystem 10. For example, in some embodiments, the guard 500 can be slidalong the axis 46 of the bore 22 to thereby exposed the patient support201 such that a patient 116 can be placed on the patient support 201.After the patient 116 is placed on the patient support 201, the guard500 can then be slid to a closed position, such as that shown in FIG.16C. In further embodiments, the guard 500 can be coupled (e.g.,slidably secured, rotatably secured, or detachably secured) to thepatient support 201, which allows the guard 500 to be positioned inconjunction with the patient support 201. In such cases, if the patientsupport 201 is translated along the axis 46 of the bore 22, the guard500 will move with the patient support 201. In some embodiments, if thepatient support 201 is positioned between the first operative positionassociated with the radiation source 40, and the second operativeposition associated with the device 166, the guard 500 that is coupledto the patient support 201 will move with the patient support 201. Inthe case in which the device 166 includes a moving part, such as arotating gantry, the guard 500 can also protect the patient 116 frombeing collided with the moving component of the device 166.

In some embodiments, if the guard 500 is coupled to the patient support201, the guard 500 can be made sufficiently small such that it can fitwithin the bore 22 of the radiation system 10 in different orientations.Such allows the patient 116 to be treated in different non-coplanarmanners. In other embodiments, if the guard 500 is coupled to theradiation system 10, the cross sectional size of the guard 500 (and thebore 22) can be made sufficiently large to allow the patient support 201to be oriented in a non-coplanar manner within the guard 500. In furtherembodiments, when treating the patient 116 in a non-coplanar manner, theguard 500 is decoupled (or retracted) from the radiation system 10and/or the patient support 201, and is not used.

It should be noted that the protective guard 500 is not limited to beingused with the radiation system 10 (e.g., any of the radiation systems 10in FIGS. 1A-1F). In other embodiments, the guard 500 can be used withother treatment devices or imaging devices. For examples, in otherembodiments, the guard 500 can be included or used with a conventionalCT machine.

In any of the embodiments of the radiation system 10 described herein,the radiation system 10 can further include a guard that covers at leasta portion of the arm 30. For example, the guard can be a cylindricalstructure that is placed around the arm 30 and in a coaxial relationshipwith the bore 22. The guard prevents, or at least reduce the risk of, acollision by the arm against a person, such as an operator of theradiation system 10.

In any of the embodiments of the radiation system 10 described herein,the radiation system 10 can further include a PET device secured next tothe radiation source 40. FIG. 17A illustrates a variation of theradiation system 10 that includes two PET imagers 600 a, 600 b. The PETimagers 600 a, 600 b are located next to the radiation source 40, andopposite from each other across the opening 19. The positions of the PETimagers 600 a, 600 b can be adjusted using the mechanical linkages 604.In the illustrated embodiments, the radiation system 10 also includes animager 606, which is similar to the imager 50 discussed previously withreference to FIG. 1B. The imager 606 is located opposite from theradiation source 40 across the opening 19 (at an operative position inassociation with the radiation source 40). The configuration of theradiation system 10 should not be limited to the examples discussedpreviously, and that the radiation system 10 can have otherconfigurations in other embodiments. For example, in other embodiments,instead of having the arm 30, the radiation system 10 can have a ringgantry with a slip-ring configuration (e.g., such as that described withreference to FIG. 1F). In such cases, the structure 12 of the radiationsystem 10 can further include a PET device secured next to the ringgantry. For example, the PET device may comprise imagers 600 a and 600 battached to a ring. The radiation source 40 and the imager 606 may alsobe secured to the same ring. Alternatively, the PET device may include aPET imager having a ring configuration formed as part of the system 10,e.g, within the bore of system 10.

During use, the radiation source 40 can be used to deliver treatmentradiation to treat a patient while the patient is positioned at thefirst operative position associated with the radiation source 40. Theradiation source 40 can also be used to deliver low dose radiation toobtain an image (e.g., using the imager 606) of a portion of the patientwhile the patient is at the first operative position. In such cases, thecollimator next to the radiation source 40 may be opened to provide animaging window for allowing the imaging radiation to pass therethrough.The PET imagers 600 a, 600 b can be used to obtain PET image data of aportion of the patient while the patient is at the first operativeposition. Such feature is advantageous in that it allows PET image datafrom the PET imagers 600 a, 600 b, and image data from the imager 606,to be collected without moving the patient support. The imagers 600 aand 600 b can be rotated to obtain data at a plurality of angularpositions, to provide more data for volumetric reconstruction.

In some embodiments, the radiation system 10 of FIG. 17A can be usedwith the device 166, as similarly discussed with reference to FIG. 2.During use, the patient can be placed at the operative positionassociated with the device 166, and the device 166 can be used to createa treatment plan for the patient. At least a portion of the patient isthen transferred from the operative position associated with the device166, through the bore 22 and the bore 56, to the operative positionassociated with the radiation source 40, where the patient can betreated and/or imaged by the radiation source 40 and/or the imagers 600a, 600 b, or by the imaging devices 51 and 52 of FIG. 1D.

In other embodiments, instead of the configuration shown in FIG. 17A,the radiation system 10 does not include the PET imagers 600 a, 600 b(FIG. 17B). Instead, the radiation system 10 is used with, or includes,the device 166, which includes PET imager(s) (for example, the device166 may include two PET imagers (or multiple sets of two imagers)secured to a ring and positioned opposite from each other, oralternatively, the device 166 may include a PET imager having astationary ring configuration. In such cases, the patient is positionedat the second operative position associated with the device 166, and thePET imager(s) are used to obtain PET image data of a portion of thepatient. The portion of the patient is then positioned through the bore22 of the structure 12 and through the bore 56 of the arm 30 until it isat the first operative position associated with the radiation source 40.The radiation source 40 then delivers low dose radiation beam to obtainimage data (e.g., using the imager 606) of the portion of the patient.In other embodiments, the image data can be obtained before the PETimage data. The configuration of the radiation system 10 should not belimited to the examples discussed previously, and that the radiationsystem 10 can have other configurations in other embodiments. Forexample, in other embodiments, instead of having the arm 30, theradiation system 10 can have a ring gantry with a slip-ringconfiguration. Also, in other embodiments, instead of, or in additionto, PET imagers, the device 166 can include one or more SPECT imagers.Similarly, in other embodiments, imagers 600 a, 600 b and/or 606 may beSPECT imagers.

In any of the embodiments described herein, image data obtained usingthe imager 606 can be used to perform attenuation correction for the PETimage data (to correct attenuation effect in PET). This is advantageousbecause PET photons, having an energy of approximately 511 keV, undergosignificant Compton scattering, while attenuation of x-rays of typicaldiagnostic sources generally are dominated by the photoelectric effect.Photons from the treatment beam are typically in the MeV range, and likethe PET photons, the attenuation is dominated by Compton scattering.Thus, the attenuation data from the treatment beam may provide a bettermeasure of attenuation. In addition, since a PET image may not provide adesired image resolution, the image data obtained using the imager 606can be used to correct certain features of the PET image data. In someembodiments, the image data (whether from imager 606 or other imagingdevice) and the PET image data are combined to form a composite image,which may be used for treatment planning and/or for treatmentevaluation. The composite image may be used during a treatment process.For example, the composite image may be used to verify a location of atarget tissue region and/or to show the areas where a tumor is activelygrowing. As a further exemplary alternative, the imaging devices 51 and52 may be used to obtain data for attenuation correction, and/or for usein forming a composite image.

Various techniques may be employed for collecting the image data fromthe imager 606 and the PET image data from the PET imagers 600 a, 600 b.For example, in some embodiments, the radiation source 40 and the imager606 may be rotated around the patient to collect a plurality of imagedata at a plurality of gantry angles. Afterwards, the PET imagers 600 a,600 b are then used to collect PET image data. In some cases, the PETimagers 600 a, 600 b may be rotated around the patient to collect adesired set of PET image data. If a ring-shape PET imager is used(instead of the set of PET imagers 600 a, 600 b), then the ring-shapePET imager needs not be rotated. In other embodiments, instead ofcollecting the image data before the PET image data, the PET image datamay be collected first, followed by the image data from the imager 606.In further embodiments, a set of image data from the imager 606 and PETimage data from the PET imagers 600 a, 600 b may be collected at a firstgantry angle. The gantry is then rotated to thereby collect another setof image data from the imager 606 and PET image data from the PETimagers 600 a, 600 b at a second gantry angle. The rotation of thegantry, and the collection of image and PET image data are continued,until a desired amount of image data and/or PET image data is collected.The collected image data and PET image data are transmitted to aprocessor, such as the processor 84, which processes the image data andthe PET image data. In some embodiments, the processor uses the imagedata to perform attenuation correction for the PET image data, asdiscussed herein. In other embodiments, the processor may use the imagedata and the PET image data to construct a composite image, as alsodiscussed herein.

FIG. 17C illustrates a radiation system 10 in accordance with otherembodiments. The radiation system 10 includes the structure 12, whichhas the first side 14, the second side, the first opening 18 located onthe first side 14, the second opening 20 located on the second side, andthe bore 22 extending between the openings 18, 20. In the illustratedembodiments, the radiation system 10 further includes a first ring 630a, and a second ring 630 b. Each of the rings 630 a, 630 b may be acomplete ring or a partial ring (e.g., an arc). The rings 630 a, 630 bare independently rotatable relative to the structure 12, therebyallowing the rings 630 a, 630 b to rotate at different speeds. Each ofthe rings 630 can be used to carry different devices. In the illustratedembodiments, the first ring 630 a may be used to carry a treatmentradiation source (such as an embodiment of the radiation source 40described herein), and the second ring 630 b may be used to carry anx-ray tube 640 and an imager 642 (which for example, may be componentsof a CT device). The first ring 630 a is also used to carry the imager50, such that image data can be obtained using the treatment radiationsource 40 and the imager 50. In any embodiment, the first ring 630 a canhave one or more diagnostic sources, and one or more imagers. Duringuse, the first ring 630 a can rotate at a first speed to treat a patientand/or to generate image data using the radiation source and the imager,and the second ring 630 b can rotate at a second speed to generate CTimage data using the x-ray tube 640 and the imager 642, wherein thefirst and the second speeds are different. In some embodiments, the CTdevice on the second ring 630 b can be used to obtain an image of aportion of a patient while the patient is being treated using theradiation source 40 on the first ring 630 a.

It should be noted that the devices that can be attached to the rings630 a, 630 b are not limited to the examples discussed previously. Forexample, in other embodiments, a diagnostic device, such as a PET device(e.g., PET imager(s)), can be secured to the second ring 630 b. In suchcases, the image data obtained from the imager on the first ring 630 amay be used to perform attenuation correction for PET image obtainedusing the PET device on the second ring 630 b, or may be used with thePET image data to form a composite image. The first and the second rings630 a, 630 b can be configured to rotate at the same speed or differentspeeds to obtain a desired result. Also, in some embodiments, the firstring 630 a can be configured to rotate by a first range of gantry angleto perform a first procedure, and the second ring 630 b can beconfigured to rotate by a second range of gantry angle to perform asecond procedure. The first and the second range may be the same ordifferent, and may or may not overlap each other.

In further embodiments, the PET device may include a ring-shape PETimager. In such cases, the radiation system 10 of FIG. 17C includes onering 630 a, and does not include a second rotatable ring. For example,the second ring 630 b may be fixedly secured to the structure 12 suchthat the second ring 630 b is not rotatable relative to the structure12, and may be used as a support to which the ring-shape PET imager ismounted. The ring-shape PET imager is secured within the bore 22 next tothe first ring 630 a. During use, image data are obtained using theradiation source 40 and the imager 50 mounted on the first ring 630 a,and the image data may be used to correct attenuation effect in PETimage data obtained using the ring-shape PET imager.

In further embodiments, the second ring 630 b may carry a component,such as an imager, that is a part of an imaging device. By means ofnon-limiting examples, the imaging device may be a laminar tomographydevice, a MRI device, a fluoroscope, an angiography device, a SPECTdevice, or a tomosynthesis imaging device. Also, in further embodiments,instead of or in addition to having multiple rings such as rings 630 a,630 b in the same structure 12, the radiation system 10 can have a firststructure (e.g., structure 12) that carries the first ring 630 a, and asecond structure that carries the second ring 630 b. The first andsecond structures may be dockable relative to one another, using forexample, the embodiments described previously. In general, in anyembodiment, each ring may carry one or more devices, each structure maycarry one or more rings, and each structure may be dockable

FIG. 17D illustrates a top view of a radiation system 10 in accordancewith other embodiments. The radiation system 10 includes a first device700 and a second device 702 that is oriented at 90° relative to thefirst device 700 (e.g., axis 704 associated with the first device 700forms a 90° relative to axis 706 associated with the second device 702).In some embodiments, the first device 700 may be any of the embodimentsof the radiation systems 10 (e.g., any of the devices of FIGS. 1A-1F)described herein. In other embodiments, the first device 700 may be atreatment machine or a diagnostic machine having other configurations.For example, the first device 700 may be a radiation treatment machinethat does not have the through bore 22. Also, in some embodiments, thesecond device 702 may be any of the embodiments of the devices 166 (ordevice 100) described herein, or any treatment or diagnostic device notdescribed herein. By means of non-limiting examples, the second device702 may be a CT device (e.g., a CBCT device), a laminar tomographydevice, a MRI device, a fluoroscope, an angiography device, a PETdevice, a SPECT device, a PET-CT device, or a tomosynthesis imagingdevice. During use, the patient positioning system 200 places a patientin a first operative position associated with the first device 700 toallow a first procedure, such as a treatment procedure, be performed onat least a portion of the patient. The patient positioning system 200then places the patient in a second operative position associated withthe second device 702 to allow a second procedure, such as an imagingprocedure, be performed on at least a portion of the patient. Asillustrated in the embodiments, orienting the devices 700, 702 90°relative to each other is advantageous in that it allows a patient to betransported between two devices in a relatively short distance. Also,such placement of the first and second devices 700, 702 may allow themto be placed in a room having limited dimensions.

The radiation system 10 of FIG. 17D is not limited to the configurationshown. In further embodiments, the axis 704 of the first device 700 mayform an angle with the axis 706 of the second device 702 that is lessthan 90°. For example, as shown in FIG. 17E, the first device 700 andthe second device 702 may be positioned in a side-by-side configuration,wherein the axis 704 forms a 0° relative to the axis 706. During use,the patient positioning system 200 places a patient in a first operativeposition associated with the first device 700 to allow a firstprocedure, such as a treatment procedure, be performed on at least aportion of the patient. The patient positioning system 200 then placesthe patient in a second operative position associated with the seconddevice 702 to allow a second procedure, such as an imaging procedure, beperformed on at least a portion of the patient. In some embodiments, thepatient positioning system 200 of FIG. 13A may be used with theradiation system 10 of FIG. 17E. As illustrated in the embodiments,orienting the devices 700, 702 90° or less relative to each other isadvantageous in that it allows a patient to be transported between twodevices in a relatively short distance. Also, such placement of thefirst and second devices 700, 702 may allow them to be placed in a roomhaving limited dimensions.

In further embodiments, the axis 704 of the first device 700 may form anangle with the axis 706 of the second device 702 that is more than 90°,e.g., between 90° and 180°. Such configuration may be desirable toaccommodate the devices 700, 702 in an operating room having certainsize and shape.

FIG. 18 illustrates a schematic block diagram of a radiation beamgenerator 750 for providing the radiation beam 42 in accordance withsome embodiments. The radiation beam generator 750 may be implemented inany of the embodiments of the radiation system 10 described herein. Theradiation beam generator 750 includes a particle source 752 (e.g., anelectron generator) for generating particles (e.g., electrons), theaccelerator 31 for accelerating the particles, and a permanent magnetsystem 754 for altering a trajectory of the particles. The permanentmagnet system 754 includes one or more permanent magnet(s). In theillustrated embodiments, the permanent magnet system 754 changes adirection of the beam by approximately 270°. Use of a permanent magnetsystem 754 to change the trajectory of the beam is advantageous becauseit allows the overall size of the radiation beam generator 750 bereduced (as compared to use of an electromagnetic system, which wouldincrease the size of the generator 750).

In some embodiments, the radiation beam generator 750 may furtherinclude one or more electromagnet(s) to alter a characteristic of themagnetic field provided by the permanent magnet system 754. In suchcases, the electromagnetic coils may magnetically couple with thepermanent magnetic to make changes (e.g., 30% or less) in the magneticfield that is used to bend the beam. For example, the electromagnet(s)may be configured (e.g., sized, shaped, and positioned relative to thepermanent magnet 754) to provide a magnetic field to change a magnitudeand/or a direction of the magnetic field provided by the permanentmagnet system 754, thereby allowing the generated beam to be “bent” in adesired manner. The electromagnet(s) may be positioned adjacent to thepermanent magnet system 754, or connected to the permanent magnet system754. In other embodiments, instead of using electromagnet(s), theradiation beam generator 750 may include one or more additionalpermanent magnet(s) for adjusting a magnetic field provided by thepermanent magnet system 754. For example, the additional permanentmagnet may be secured to a positioner that moves the additionalpermanent magnet relative to the permanent magnet system 754, therebychanging a magnitude and/or a direction of the magnetic field providedby the permanent magnet system 754. In other embodiments, othertechniques known in the art may be used to vary the magnetic coupling ofa magnetic material or magnet in the magnetic circuit to thereby providethe magnetic trimming functionality.

Computer System Architecture

FIG. 19 is a block diagram illustrating an embodiment of a computersystem 800 that can be used to implement various embodiments of themethod described herein. Computer system 800 includes a bus 802 or othercommunication mechanism for communicating information, and a processor804 coupled with the bus 802 for processing information. The processor804 may be an example of the processor 84/134, or alternatively, anexample of a component of the processor 84/134. The computer system 800also includes a main memory 806, such as a random access memory (RAM) orother dynamic storage device, coupled to the bus 802 for storinginformation and instructions to be executed by the processor 804. Themain memory 806 also may be used for storing temporary variables orother intermediate information during execution of instructions to beexecuted by the processor 804. The computer system 800 further includesa read only memory (ROM) 808 or other static storage device coupled tothe bus 802 for storing static information and instructions for theprocessor 804. A data storage device 810, such as a magnetic disk oroptical disk, is provided and coupled to the bus 802 for storinginformation and instructions.

The computer system 800 may be coupled via the bus 802 to a display 87,such as a cathode ray tube (CRT), or a flat panel display, fordisplaying information to a user. An input device 814, includingalphanumeric and other keys, is coupled to the bus 802 for communicatinginformation and command selections to processor 804. Another type ofuser input device is cursor control 816, such as a mouse, a trackball,or cursor direction keys for communicating direction information andcommand selections to processor 804 and for controlling cursor movementon display 87. This input device typically has two degrees of freedom intwo axes, a first axis (e.g., x) and a second axis (e.g., y), thatallows the device to specify positions in a plane.

In some embodiments, the computer system 800 can be used to performvarious functions described herein. According to some embodiments of theinvention, such use is provided by computer system 800 in response toprocessor 804 executing one or more sequences of one or moreinstructions contained in the main memory 806. Those skilled in the artwill know how to prepare such instructions based on the functions andmethods described herein. Such instructions may be read into the mainmemory 806 from another computer-readable medium, such as storage device810. Execution of the sequences of instructions contained in the mainmemory 806 causes the processor 804 to perform the process stepsdescribed herein. One or more processors in a multi-processingarrangement may also be employed to execute the sequences ofinstructions contained in the main memory 806. In alternativeembodiments, hard-wired circuitry may be used in place of or incombination with software instructions to implement the invention. Thus,embodiments of the invention are not limited to any specific combinationof hardware circuitry and software.

The term “computer-readable medium” as used herein refers to any mediumthat participates in providing instructions to the processor 804 forexecution. Such a medium may take many forms, including but not limitedto, non-volatile media, volatile media, and transmission media.Non-volatile media includes, for example, optical or magnetic disks,such as the storage device 810. Volatile media includes dynamic memory,such as the main memory 806. Transmission media includes coaxial cables,copper wire and fiber optics, including the wires that comprise the bus802. Transmission media can also take the form of acoustic or lightwaves, such as those generated during radio wave and infrared datacommunications.

Common forms of computer-readable media include, for example, a floppydisk, a flexible disk, hard disk, magnetic tape, or any other magneticmedium, a CD-ROM, any other optical medium, punch cards, paper tape, anyother physical medium with patterns of holes, a RAM, a PROM, and EPROM,a FLASH-EPROM, any other memory chip or cartridge, a carrier wave asdescribed hereinafter, or any other medium from which a computer canread.

Various forms of computer-readable media may be involved in carrying oneor more sequences of one or more instructions to the processor 804 forexecution. For example, the instructions may initially be carried on amagnetic disk of a remote computer. The remote computer can load theinstructions into its dynamic memory and send the instructions over atelephone line using a modem. A modem local to the computer system 800can receive the data on the telephone line and use an infraredtransmitter to convert the data to an infrared signal. An infrareddetector coupled to the bus 802 can receive the data carried in theinfrared signal and place the data on the bus 802. The bus 802 carriesthe data to the main memory 806, from which the processor 804 retrievesand executes the instructions. The instructions received by the mainmemory 806 may optionally be stored on the storage device 810 eitherbefore or after execution by the processor 804.

The computer system 800 also includes a communication interface 818coupled to the bus 802. The communication interface 818 provides atwo-way data communication coupling to a network link 820 that isconnected to a local network 822. For example, the communicationinterface 818 may be an integrated services digital network (ISDN) cardor a modem to provide a data communication connection to a correspondingtype of telephone line. As another example, the communication interface818 may be a local area network (LAN) card to provide a datacommunication connection to a compatible LAN. Wireless links may also beimplemented. In any such implementation, the communication interface 818sends and receives electrical, electromagnetic or optical signals thatcarry data streams representing various types of information.

The network link 820 typically provides data communication through oneor more networks to other devices. For example, the network link 820 mayprovide a connection through local network 822 to a host computer 824 orto equipment 826, such as any of the devices herein (e.g., device 166,system 10, patient support system 200, etc.), or a switch operativelycoupled to any of the devices described herein. The data streamstransported over the network link 820 can comprise electrical,electromagnetic or optical signals. The signals through the variousnetworks and the signals on the network link 820 and through thecommunication interface 818, which carry data to and from the computersystem 800, are exemplary forms of carrier waves transporting theinformation. The computer system 800 can send messages and receive data,including program code, through the network(s), the network link 820,and the communication interface 818.

Although particular embodiments of the present inventions have beenshown and described, it will be understood that it is not intended tolimit the present inventions, and it will be obvious to those skilled inthe art that various changes and modifications may be made withoutdeparting from the spirit and scope of the present inventions. Forexample, the term “image” or “image data” as used in this specificationincludes image data that may be stored in a circuitry or acomputer-readable medium, and should not be limited to image data thatis displayed visually. Also, it should be noted that in otherembodiments, the radiation system 10 may not include one or more of thecomponents described herein. Further, in other embodiments, theradiation system 10 may include any of the components described herein,even if the components are described as separate elements from theradiation system 10. The specification and drawings are, accordingly, tobe regarded in an illustrative rather than restrictive sense. Thepresent inventions are intended to cover alternatives, modifications,and equivalents, which may be included within the spirit and scope ofthe present inventions as defined by the claims.

1. A radiation system, comprising: a structure having a first side, asecond side, a first opening located on the first side, a second openinglocated on the second side, and a bore extending between the firstopening and the second opening; a first radiation source configured foremitting treatment radiation, wherein the first radiation source iscoupled to the structure and is located outside the bore, wherein thefirst radiation source is located closer to the first side than thesecond side of the structure; a diagnostic device located closer to thesecond side than the first side of the structure, and is next to thestructure; a positioner; and a patient support secured to thepositioner; wherein the patient support is configured to support asubject, and wherein the positioner is configured to position thesubject through the bore from the first side to the second side to reachan operative position associated with the diagnostic device.
 2. Theradiation system of claim 1, wherein the diagnostic device comprises asecond radiation source.
 3. The radiation system of claim 2, wherein thesecond radiation source comprises a diagnostic radiation source.
 4. Theradiation system of claim 2, wherein the second radiation source isconfigured to emit a fan beam.
 5. The radiation system of claim 2,wherein the second radiation source is configured to emit a cone beam.6. The radiation system of claim 1, further comprising a support armcoupled to the structure, wherein the first radiation source is securedto the support arm, and is spaced away from the structure.
 7. Theradiation system of claim 1, wherein the patient support has a free endthat remains unsupported during a medical procedure as the positionerpositions the subject through the bore from the first side to the secondside to reach the operative position associated with the diagnosticdevice.
 8. The radiation system of claim 1, wherein the diagnosticdevice comprises a component that is a part of an imaging device, theimaging device selected from the group consisting of a CT device, alaminar tomography device, a MRI device, a fluoroscope, an angiographydevice, a PET device, a PET-CT device, and a SPECT device.
 9. Theradiation system of claim 1, wherein the structure is configured tosupport the first radiation source.
 10. The radiation system of claim 1,wherein the first radiation source is rotatably coupled to thestructure, and is translatable in a direction that is parallel to anaxis of the bore.
 11. The radiation system of claim 1, wherein thediagnostic device is located closer to the second side than the firstside of the structure during use of the diagnostic device.
 12. Theradiation system of claim 1, wherein the diagnostic device is directlybehind the structure.
 13. The radiation system of claim 1, wherein thestructure and the diagnostic device are located in a same room.
 14. Theradiation system of claim 13, wherein the structure and the diagnosticdevice are arranged in a side-by-side configuration.